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Gallstones and gallbladder function

Background

  • Gallstones are hard, pebble-like deposits that form inside the gallbladder. There are two main types of gallstones:
  • Gallstones are an ancient entity, having occurred more than 3500 years ago, according to autopsies performed on Egyptian and Chinese mummies.
  • The gallbladder is a small organ situated underneath the liver. The gallbladder stores bile, a fluid which is released into the small intestine during digestion, where it emulsifies fats and assists their digestion.
    • Stones made out of cholesterol. Gallstones made out of cholesterol are by far the most common type, responsible for 80% of cases1.
    • Stones made from too much bilirubin (the main pigment found in bile). Such stones are called pigment stones and, in Europe, are responsible for 15% of gallstone cases1.
  • The large majority of people who have gallstones have no symptoms (non-symptomatic gallstones). However, in a minority of cases, gallstones trigger severe abdominal pain (symptomatic gallstones). In these instances, the gallstones cause the gallbladder to become inflamed and this leads to gallbladder disease.

The scale of the issue

  • Gallstones are very common:
    • Across Europe, studies have shown that gallstones affect between 6-22% of the population2.
    • It is estimated that over 20 million individuals in the United States have gallbladder disease3.
    • In the US, gallbladder disease has a low mortality rate of 0.6%, but considering how common gallstones are, there were still an estimated 1092 gallstone-related deaths in 20044.
    • In the US, gallstone-related deaths have steadily declined from more than 5000 deaths in 1950, falling more than 50% between 1979 and 2004. This decline represents the greatest decrease for any digestive disease4.
  • Approximately 80% of people with gallstones will not suffer any symptoms linked to the presence of gallstones5.

References
1 Gallstones – Medicine Net: http://www.medicinenet.com/gallstones/page2.htm
2 R. Aerts and F. Penninckx (2003), The burden of gallstones disease in Europe, Aliment Pharmacol Ther, 18(Suppl):349–353.
3 Everhart J E et al. (1999), Prevalence and ethnic differences in gallbladder disease in the United States. Gastroenterol, 117:3:632-639.
4 J.E. Everhart and C.E. Ruhl (2009), Burden of digestive diseases in the United States part I: overall and upper gastrointestinal diseases, Gastroenterology, 136(2):376–386.
5 NHS. Gallstones. www.nhs.uk/conditions/gallstones/Pages/Introduction.aspx

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