How to prevent gallstones?

Gallstones are among the most common gastrointestinal disorders in Western populations. Interestingly, there are preventative guidelines that could help you to avoid gallstone formation. A healthy diet with low-fat content, a high-fiber diet, regular physical activity, low total calorie intake, increase vitamin C, and omega-3 intake, avoiding iron deficiency, and other healthy lifestyle strategies could help you to prevent gallstone formation. Find more details with evidence-based information in this article.

Overview | Gallstones prevention | Summary

General overview

Gallstones are among the most common gastrointestinal disorders in Western populations.

In the USA, In 2004,

There were an estimated 1.8 million ambulatory care visits with a diagnosis of gallstones
The visit rates increased with age, although only modestly after age 65 years.
Visit rates were 18% higher among whites than blacks and 162% higher for females than males (Ref).

Moreover, Gallstones ranked 5th among digestive diseases in all-listed discharge diagnoses in 2004 in the USA.

In addition, the hospitalization with gallstones increased with age, was similar for blacks and whites, and was 58% higher for women than men. The question now is how to prevent gallstone formation. Let’s simply illustrate the available approaches to prevent or avoid gallstone formation

Gallstones prevention:

Certain approaches are available for the prevention of gallstone formation. Mostly related to changing your lifestyle into a healthy pattern. The most beneficial approaches are listed below.

For the general population:

Pharmacological prevention is not recommended however, lifestyle change is the best choice

Maintain healthy body weight.

Reducing body weight in obese and overweight populations has a preventative role in gallstone formation.

Avoid rapid weight loss which is associated with an increased risk of gallstone formation.

Limitation of weight loss to a moderate rate (maximum of 1.5 kg/week) has been recommended to prevent gallstone formation (Ref)

Prevent insulin resistance in type 2 diabetes mellitus

Insulin resistance plays an important role in gallstone formation, thus, the prevention of insulin resistance in patients with type 2 diabetes could significantly lower their risk to have gallstones.

Regular physical exercise.

The regular moderate activity could protect you against gallstones and decrease the risk of symptomatic stones by 30 %.
Physical activity improves your intestinal motility and facilitates your gallbladder emptying.
Also, physical activity affects several metabolic pathways associated with gallstone formation such as hyperinsulinemia (increased insulin level in your blood) and hypertriglyceridemia (increased level of triglyceride in your blood), and levels of HDL cholesterol (HDL levels are inversely related to gallstone prevalence).

Regular eating habits:

This means avoiding skipping breakfast and decreasing the interval between dinner and the next meal (Ref).
The regular eating pattern leads to a decrease in the cholesterol saturation in your bile and decreases gallbladder stasis and promotes gallbladder emptying.

Fiber-rich diet:

Fiber increases your intestinal motility, facilitates your digestion, and reduces the biliary concentration of bile acids.

In observational studies, a higher intake of fiber was associated with a lower prevalence of gallstones (Ref)

Reduce calories intake

A hypercaloric diet increases your risk to have gallstones. Thus, reducing the total calorie intake could provide a preventative role against gallstone formation.

Iron supplement

The iron supplement was found to play role in gallstone formation.

An animal study showed that dogs fed an iron-deficient diet had a higher incidence of cholesterol crystals in their bile than animals fed a control diet.

These findings increase the possibility that iron deficiency plays a role in the pathogenesis of gallstone formation in humans.

Omega-3 and polyunsaturated fatty acids

The supplementation with fish oil (omega-3; a polyunsaturated fatty acid) might prevent biliary cholesterol crystallization during rapid weight loss (Ref).

A study showed that in patients with gallstones, supplementation with 11.3 g per day of fish oil (rich in polyunsaturated fatty acids) decreased the cholesterol saturation of bile by 25 percent.

Both omega-3 and -6 polyunsaturated fatty acids may have a protective effect against gallstones formation

Healthy diet

Fruits (especially vitamin C-containing fruits), vegetables, polyunsaturated fats, monounsaturated fats, and nut consumption could help you to lower your risk of gallstone formation.

A study published in 2000 evaluated the role of vitamin C (ascorbic acid and the prevalence of gallstones. Researchers revealed that:
- There was an inverse relationship between the serum level of ascorbic acid (vitamin C) and the prevalence of gallbladder disease among women.
- Moreover, they found that ascorbic acid supplements were associated with a lower prevalence of clinical gallbladder disease.

Another study published in the Journal of Nutrition showed that
- The polyunsaturated fatty acids, omega-3 help obese women during rapid weight loss to prevent gallstone formation.
- Researchers suggest that dietary recommendations for obese women during the time of rapid weight loss could help in gallstone prevention at this time.

A study published in the journal of the American College of Nutrition provided a general conclusion about several factors related to gallstone prevention. The authors reported that:
- Patients with gallstones consumed less food per day (g/day) and less fish and fruits than did individuals without gallstones.
- Gallstones patients were reported to eat fewer meals [per day, with greater sugar and meat intake than those with no gallstones.
- Moreover, patients with gallstones were found to spend less time walking and sleeping than those without gallstones.
- Those with gallstones had a fluctuation in body weight with greater frequency and consumed more total calories, fats (saturated fatty acids), and less fiber than those without gallstones.

For high-risk individuals:

Specific preventive measures have been recommended for people who are at high risk. These involve the following:

Temporary administration of ursodeoxycholic acid (UDCA, at least 500 mg per day until body weight stabilizes). This could prevent the formation of cholesterol gallstones following rapid weight reduction.

Patients using somatostatin and its various analogs (patients with neuroendocrine tumors) are at a higher risk of developing gallstones. Thus, concomitant treatment with ursodeoxycholic acid (UDCA) may prevent gallstone formation in most cases (Ref).

Take care, you shouldn’t use any medication before consulting your doctor.

Note:

No recommendation for prevention can currently be given for patients on total parenteral nutrition, pregnant women, and patients undergoing hormone-replacement therapy, however, these groups are at a higher risk of gallbladder sludge and/or stone formation (Ref).

Summary:

Lifestyle change represents the main point for gallstone prevention.
Maintaining a healthy weight, avoiding sudden weight loss, regular physical activity, decreasing total calorie intake, and increase your intake of vitamin C, and omega-3, increasing a fiber-rich diet, avoid iron deficiency represent the main brilliant points for gallstone prevention.

Read more about: