Philip J. Goscienski, M.D.
September 2009
Hundreds of thousands of Americans are walking around without a gallbladder and seem none the worse for it. Considering how much pain, misery and expense it causes and how little we miss it after it's gone you might wonder why nature even bothered to supply us with one.
The gallbladder is a sac about the size of one's thumb that stores bile, a complex fluid that is produced in the liver and that we need for digestion. All mammals have a gallbladder but modern humans' peculiar diet has turned this benign little bag of bile into a common nuisance. Surgeons remove several hundred thousand gallbladders every year at a cost of more than 6 billion dollars annually in the United States.
A variety of conditions lead to the formation of gallstones, pesky pebbles that sometimes block the flow of bile. Besides causing extreme pain in some patients the obstruction can also lead to inflammation of the gallbladder and the need to remove it.
Gallbladder removal using several small incisions — laparoscopic surgery — is common, leaving tiny scars that are not worth showing off. Brief anesthesia, short hospital stays and fewer complications have removed almost all the risk.
About 20 percent of us have stones in our gallbladder and most of them won't ever become a problem. About 80 percent are composed of cholesterol and they are most likely to form in persons who are overweight. Rapid weight loss diets, losing more than about two pounds a week, actually increase the risk of gallbladder problems. Persons who habitually enjoy a high fat diet form more cholesterol than normal, which eventually leads to the formation of cholesterol stones. Once formed, gallstones don't melt away on their own and there is no dietary regimen that will do it, either. Prescription drugs that dissolve gallstones are expensive and require months of treatment.
The likelihood of needing gallbladder surgery rises in almost direct proportion to body fat. Simply being female is a risk factor, possibly because hormones play a role in cholesterol metabolism. There is also a slightly greater risk among women who have had several pregnancies. Some normal-weight people, especially Native Americans and those of Chilean ancestry, have a genetic tendency toward gallbladder disease.
The fattening of America promises to keep surgeons in business for a long time.
Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.