Ethnicity and gallstones

Q. I’m from an Italian-American family, and we seem to have a predisposition for gallstones. Is this something people of my ethnic background get more often?

I could find no evidence that people with an Italian background get more gallstones than others. However, Native Americans have an inclination for this malady; they have the highest rate of gallstones in the United States.

There is a bunch of other risk factors. People over age 60 are more likely to develop gallstones than younger people. Women between 20 and 60 years of age are twice as likely to develop gallstones as men. Other factors include obesity, excess estrogen, cholesterol-lowering drugs, diabetes, rapid weight loss, and fasting.

The gallbladder is a blue-green organ, about three inches long on the underside of the liver.

The liver produces bile in a dilute form, which is then stored and concentrated in the gallbladder. The bile is then secreted from the gallbladder into the small intestine where it aids digestion.

You can live without a gallbladder. After it is removed, bile flows out of the liver through ducts into the small intestine. However, because the bile isn’t stored in the gallbladder, it flows into the small intestine more frequently.

Bile is made up of fatty substances such as cholesterol. When excessive amounts of fat are present, stones can form. The stones can be as small as a grain of sand or as large as a golf ball. About 90 percent of gallstones are composed of cholesterol.

Gallstones can block the normal flow of bile. A blockage can cause inflammation. If the blockage persists, it can damage organs and be fatal.

Symptoms of gallstones often present themselves suddenly. If you have a gallstone “attack,” you can suffer pain in the upper abdomen, between the shoulder blades, and under the right shoulder. An attack, which often comes after a fatty meal, can last from a half-hour to several hours.

Other symptoms include nausea, vomiting, indigestion, abdominal bloating, and recurring intolerance of fatty foods.

You should get to a doctor immediately if you have an attack with chills, fever, yellowing of the skin or whites of the eyes, and clay-colored stools.

About 80 percent of people with gallstones have no symptoms. They have what are called “silent stones” that don’t need treatment.

Gallstones are usually treated by removing the gallbladder. This surgery is called a “cholecystectomy.” In traditional surgery, the gallbladder is removed through an abdominal incision up to eight inches long. However, the most common method today employs a laparoscope, a thin tube with a scope on the end of it.

The laparoscope is inserted through a small incision below the navel. The surgeon can see inside with the scope. The other surgical tools are inserted in three other small incisions in your abdomen. The gallbladder is removed through one of these cuts.

Abdominal ultrasound is considered the safest and simplest of the tests for gallstones. Sonar waves from a probe are passed over the abdomen to detect the presence of stones.