Gallstones https://greenmedinfo.com/taxonomy/term/2210/all en A diet rich in refined carbohydrate increases bile cholesterol saturation and consequently gallstone formation. https://greenmedinfo.com/article/diet-rich-refined-carbohydrate-increases-bile-cholesterol-saturation-and-conse PMID:  Gut. 1983 Jan;24(1):2-6. PMID: 6293939 Abstract Title:  Diet and gall stones: effects of refined and unrefined carbohydrate diets on bile cholesterol saturation and bile acid metabolism. Abstract:  It has been suggested that consumption of refined carbohydrate foods (notably sugar and white flour) increases bile cholesterol saturation and hence the risk of cholesterol gall stone formation. To test this hypothesis, 13 subjects with probable cholesterol gall stones ate refined and unrefined carbohydrate diets, each for six weeks in random order. On the refined carbohydrate diet, subjects ate more refined sugar (mean = SEM: 106 +/- 7 vs 6 +/- 1 g/day, p less than 0.001), less dietary fibre (13 +/- 1 vs 27 +/- 3 g/day, p less than 0.001), and had a higher energy intake (9.17 +/- 0.66 vs 7.16 +/- 0.64 MJ/day, p less than 0.001). After each diet, the lipid composition of duodenal bile and bile acid kinetics was determined. The cholesterol saturation index of bile was higher on the refined carbohydrate diet in all but one subject, with a mean value of 1.50 +/- 0.10 compared with 1.20 +/- 0.12 on the unrefined diet (p less than 0.005). On the refined carbohydrate diet, bile contained relatively less cholic acid and slightly more deoxycholic acid. There were, however, no significant differences in total or individual bile acid pool sizes. There were also no differences in the rates of primary bile acid synthesis or fractional turnover on the two diets. Consumption of carbohydrate in refined form increases bile cholesterol saturation. The risk of gall stones might be reduced by avoidance of refined carbohydrate foods. https://greenmedinfo.com/article/diet-rich-refined-carbohydrate-increases-bile-cholesterol-saturation-and-conse#comments Gallstones Refined Carbohydrate Diet Human Study Thu, 23 Jul 2009 17:12:04 +0000 greenmedinfo 45869 at https://greenmedinfo.com A vegetarian diet is correlated with significantly decreased risk for gallstones in women. https://greenmedinfo.com/article/vegetarian-diet-correlated-significantly-decreased-risk-gallstones-women PMID:  Indian J Med Sci. 2003 Sep;57(9):387-93. PMID: 3926039 Abstract Title:  Effect of vegetarianism on development of gall stones in women. Abstract:  Real time ultrasonography was used to compare the prevalence of gall stones in two groups of women aged 40-69: 632 women recruited from general practice registers and 130 vegetarians. One hundred and fifty-six (25%) of the 632 women who ate meat and 15 (12%) of the 130 vegetarian women either had gall stones visible on ultrasonography or had previously undergone cholecystectomy (p less than 0.01). The prevalence of gall stones was found to increase with age and body mass index. The 2.5 fold increase in risk of developing gall stones in non-vegetarians compared with vegetarians was reduced to 1.9 when controlling for these two potentially confounding factors, but remained significant. A family history of gall stones was reported more often by women with gall stones, but no association was found with parity or use of exogenous oestrogens. Thus the importance of age and obesity to determine the prevalence of gall stone was confirmed, and a dietary factor associated with vegetarianism may prevent this common condition. https://greenmedinfo.com/article/vegetarian-diet-correlated-significantly-decreased-risk-gallstones-women#comments Gallstones Human Study Fri, 17 Jul 2009 01:24:18 +0000 greenmedinfo 45642 at https://greenmedinfo.com Both excessive ascorbic acid intake and deficiency lower biliary cholesterol saturation and bile synthesis. https://greenmedinfo.com/article/both-excessive-ascorbic-acid-intake-and-deficiency-lower-biliary-cholesterol-s PMID:  J Nutr. 1981 Mar;111(3):412-24. PMID: 7205399 Abstract Title:  Influence of chronic ascorbic acid deficiency and excessive ascorbic acid intake on bile acid metabolism and bile composition in the guinea pig. Abstract:  The influence of chronic ascorbic acid (AA) deficiency and excessive ascorbate consumption on bile acid metabolism, liver and plasma cholesterol levels, hepatic microsomal cytochromes and biliary lipid composition was investigated. Male weanling guinea pigs were fed a cereal-based scorbutigenic diet supplemented with four levels of AA for 7 weeks: deficient, 15 and 30 mg/kg; control, 500 mg/kg; and excess, 20,000 mg/kg. Bile acid kinetic parameters were determined following the intraperitoneal administration of [24-14C] chenodeoxycholic acid. Dietary extremes of AA caused similar alterations in the parameters studied. Relative to the control group, the deficient and excess groups exhibited reduced cytochrome P-450 concentration, lower cholesterol 7 alpha-hydroxylase activity, lower bile acid turnover rate, prolonged bile acid half-life and increased plasma and liver cholesterol concentrations. Deficient and excess groups also exhibited lower biliary cholesterol saturation (i.e., increased bile acid-neutral sterol ratios) than controls. Urinary bile acid excretion was 2- to 3-fold higher in excess guinea pigs than in the other three groups. The data demonstrate the exceptional susceptibility of cholesterol 7 alpha-hydroxylase activity to alteration by dietary extremes of AA, resulting in marked inhibition of bile acid synthesis and elevation of cholesterol levels by both inadequate and excessive AA intake. https://greenmedinfo.com/article/both-excessive-ascorbic-acid-intake-and-deficiency-lower-biliary-cholesterol-s#comments Cholestasis Gallstones Vitamin C Animal Study Thu, 16 Jul 2009 20:54:38 +0000 greenmedinfo 45602 at https://greenmedinfo.com Casein (cow's milk protein) consumption may be associated with gallstone formation. https://greenmedinfo.com/article/casein-cows-milk-protein-consumption-may-be-associated-gallstone-formation PMID:  Am J Clin Nutr. 1979 Nov;32(11):2174-6. PMID: 573964 Abstract Title:  Influence of vegetable protein on gallstone formation in hamsters. Abstract:  The lithogenic diet generally used for production of gallstones in hamsters contains 20% casein. In four separate experiments the 20% casein diet was compared with one containing 20% soy protein. All other components were kept constant. Two of the four experiments were of 45-day duration, one of 70 days and one of 100 days. When results of all four experiments were averaged, 57.5 +/- 3.6% of hamsters fed casein exhibited cholesterol gallstones whereas only 14.0 +/- 1.3% of soy protein-fed hamsters had gallstones. Thus, soy protein has a significant inhibitory effect on gallstone formation in hamsters. When soy protein was fed to hamsters with preestablished gallstones there was evidence of gallstone dissolution. https://greenmedinfo.com/article/casein-cows-milk-protein-consumption-may-be-associated-gallstone-formation#comments Gallstones Casein-Free Diet Animal Study Thu, 23 Jul 2009 17:08:32 +0000 greenmedinfo 45867 at https://greenmedinfo.com Cholestasis https://greenmedinfo.com/disease/cholestasis <div class="field field-image"> <div class="field-items"> <div class="field-item odd"> <img class="imagefield imagefield-field_image" width="293" height="450" alt="" src="//cdn.greenmedinfo.com/sites/default/files/GallBladderAnatomy_7.jpg?1472933887" /> </div> </div> </div> <div class="field field-copyright"> <div class="field-items"> <div class="field-item odd"> Copyright: &lt;a href=&#039;http://www.123rf.com/profile_joshyabb&#039;&gt;joshyabb / 123RF Stock Photo&lt;/a&gt; </div> </div> </div> <fieldset class="fieldgroup group-facebook-like-info"><legend>Facebook Like Info</legend><div class="field field-facebook-total-count"> <div class="field-items"> <div class="field-item odd"> 0 </div> </div> </div> </fieldset> https://greenmedinfo.com/disease/cholestasis#comments Gallstones Gallbladder Gallbladder Thu, 03 Dec 2009 19:40:30 +0000 greenmedinfo 48088 at https://greenmedinfo.com Curcumin can prevent the formation of cholesterol gallstones induced by high fat diet in mice. https://greenmedinfo.com/article/curcumin-can-prevent-formation-cholesterol-gallstones-induced-high-fat-diet-mi PMID:  Lipids Health Dis. 2015 ;14(1):100. Epub 2015 Sep 3. PMID: 26335572 Abstract Title:  Combination of curcumin and piperine prevents formation of gallstones in C57BL6 mice fed on lithogenic diet: whether NPC1L1/SREBP2 participates in this process? Abstract:  BACKGROUND: A disruption of cholesterol homeostasis characterized by the physical-chemical imbalance of cholesterol solubility in bile often results in formation of cholesterol gallstones. Our earlier studies revealed that curcumin (1000 mg/kg) could prevent formation of gallstones. It has been proved that curcumin is poorly absorbed while piperine is a bioavailability-enhancer. Nevertheless, whether curcumin combined with piperine could enhance the effect of curcumin in preventing gallstones is still awaited.METHOD: C57BL6 mice were fed on a lithogenic diet concomitant with curcumin at 500 or 1000 mg/kg and/or piperine at 20 mg/kg for 4 weeks. The ratio of gallbladder stone formation was recorded and samples of blood, bile, gallbladder, liver and small intestine were also collected. The volume of gallbladder and weight of liver were calculated, and blood and bile samples were analyzed through biochemical methods. Intestinal NPC1L1 and SREBP2 mRNA and protein expression were detected by real-time PCR and Western blot.RESULT: Combining with piperine can significantly enhance the effect of curcumin, thus preventing the development of gallbladder stones, lowering the saturation of blood lipids and cholesterol in bile, as well as decreasing the expression of NPC1L1 and SREBP2 in both mRNA and protein levels.CONCLUSION: Curcumin can prevent the formation of cholesterol gallstones induced by high fat diet in mice and SREBP2 and NPC1L1 may participate in this process. Piperine can increase curcumin&#039;s bioavailability, thereby enhancing the effect of curcumin. https://greenmedinfo.com/article/curcumin-can-prevent-formation-cholesterol-gallstones-induced-high-fat-diet-mi#comments Curcumin Gallstones High Fat Diet Piperine Increased Bioavailability Natural Substance Synergy Animal Study Tue, 08 Sep 2015 22:48:19 +0000 greenmedinfo 120290 at https://greenmedinfo.com Curcumin reduces gallstone formation and biliary cholesterol concentration in mice. https://greenmedinfo.com/article/curcumin-reduces-gallstone-formation-and-biliary-cholesterol-concentration-mic PMID:  Indian J Med Res. 1992 Oct;96:288-91. PMID: 1459671 Abstract Title:  Effect on curcumin on cholesterol gall-stone induction in mice. Abstract:  A study was carried out on the efficacy of curcumin in reducing the incidence of cholesterol gall-stones (CGS), induced by feeding a lithogenic diet in young male mice. Feeding a lithogenic diet supplemented with 0.5 per cent curcumin for 10 wk reduced the incidence of gall-stone formation to 26 per cent, as compared to 100 per cent incidence in the group fed with lithogenic diet alone. Biliary cholesterol concentration was also significantly reduced by curcumin feeding. The lithogenic index which was 1.09 in the cholesterol fed group was reduced to 0.43 in the 0.5 per cent curcumin supplemented group. Further, the cholesterol: phospholipid (C/PL) ratio of bile was also reduced significantly when 0.5 per cent curcumin supplemented diet was fed. A dose-response study with 0.2, 0.5 and 1.0 per cent curcumin supplemented lithogenic diets showed that 0.5 per cent curcumin was more effective than a diet with 0.2 or 1 per cent curcumin. https://greenmedinfo.com/article/curcumin-reduces-gallstone-formation-and-biliary-cholesterol-concentration-mic#comments Cholestasis Curcumin Gallstones Animal Study Thu, 16 Jul 2009 20:59:11 +0000 greenmedinfo 45603 at https://greenmedinfo.com Dietary fenugreek seed regresses preestablished cholesterol gallstones in mice. https://greenmedinfo.com/article/dietary-fenugreek-seed-regresses-preestablished-cholesterol-gallstones-mice PMID:  Can J Physiol Pharmacol. 2009 Sep;87(9):684-93. PMID: 19794519 Abstract Title:  Dietary fenugreek seed regresses preestablished cholesterol gallstones in mice. Abstract:  An animal study was carried out to evaluate the influence of dietary fenugreek seeds on regression of preestablished cholesterol gallstones (CGS). CGS was induced by feeding a high-cholesterol diet for 10 weeks. After CGS induction, the animals were maintained for a further 10 weeks on experimental diets of high cholesterol, 6% fenugreek powder, 12% fenugreek powder, or basal control. Incidence of CGS and its severity were evaluated at the end of this feeding regimen. The incidence of CGS was significantly lowered as a result of dietary fenugreek seeds, the extent of regression being 61% and 64% in the low and high dose groups compared with 10% regression in the basal control group. The antilithogenic influence of dietary fenugreek was accompanied by significant reductions of more than 35% in serum cholesterol concentration. Hepatic cholesterol concentration was also profoundly lowered by dietary fenugreek, being 53%-63% lower than that of the basal control diet. Biliary cholesterol concentration was significantly lower as a result of dietary fenugreek during the post-CGS induction period, resulting in a decreased cholesterol:phospholipid ratio (0.44 and 0.40 compared with 0.79 in the basal control group). Biliary cholesterol : bile acid ratio was lowered by 67% and 73% upon feeding fenugreek, significantly lower than that in the basal control group. The cholesterol saturation index in the bile was also beneficially lowered by fenugreek treatment during the post-CGS induction period (the index was 0.90 and 0.42 compared with 1.86 in the basal control group). The present study provides evidence of the potency of hypolipidemic fenugreek seeds in regressing preestablished CGS, and this beneficial antilithogenic effect is attributable to its primary influence on cholesterol levels. This finding is significant in the context of evolving a dietary strategy to address CGS, which could help in preventing the incidence and regression of existing CGS and controlling possible recurrence. https://greenmedinfo.com/article/dietary-fenugreek-seed-regresses-preestablished-cholesterol-gallstones-mice#comments Fenugreek Gallstones Animal Study Tue, 23 Feb 2010 14:57:35 +0000 greenmedinfo 52363 at https://greenmedinfo.com Dietary fiber protected against acute pancreatitis related and unrelated to gallstones, while coffees protection was unrelated to gallstones. https://greenmedinfo.com/article/dietary-fiber-protected-against-acute-pancreatitis-related-and-unrelated-galls PMID:  Clin Gastroenterol Hepatol. 2016 Sep 5. Epub 2016 Aug 5. PMID: 27609706 Abstract Title:  Dietary Factors Reduce Risk of Acute Pancreatitis in a Large Multiethnic Cohort. Abstract:  BACKGROUND &amp; AIMS: Pancreatitis is a source of substantial morbidity and health cost in the United States. Little is known about how diet might contribute to its pathogenesis. To characterize dietary factors that are associated with risk of pancreatitis by disease subtype, we conducted a prospective analysis of 145,886 African Americans, Native Hawaiians, Japanese Americans, Latinos, and whites in the Multiethnic Cohort.METHODS: In the Multiethnic Cohort (age at baseline, 45-75 y), we identified cases of pancreatitis using hospitalization claim files from 1993 through 2012. Patients were categorized as having gallstone-related acute pancreatitis (AP) (n = 1210), AP not related to gallstones (n = 1222), or recurrent AP or suspected chronic pancreatitis (n = 378). Diet information was obtained from a questionnaire administered when the study began. Associations were estimated by hazard ratios and 95% confidence intervals using Cox proportional hazard models adjusted for confounders.RESULTS: Dietary intakes of saturated fat (P trend = .0011) and cholesterol (P trend = .0008) and their food sources, including red meat (P trend<p><a href="https://greenmedinfo.com/article/dietary-fiber-protected-against-acute-pancreatitis-related-and-unrelated-galls" target="_blank">read more</a></p> https://greenmedinfo.com/article/dietary-fiber-protected-against-acute-pancreatitis-related-and-unrelated-galls#comments Coffee Fiber Gallstones Pancreatitis Risk Reduction Human Study Mon, 31 Oct 2016 18:59:39 +0000 greenmedinfo 138664 at https://greenmedinfo.com Dietary garlic and onion reduce the incidence of diet-induced cholesterol gallstones in mice. https://greenmedinfo.com/article/dietary-garlic-and-onion-reduce-incidence-diet-induced-cholesterol-gallstones- PMID:  Pharmazie. 2003 Oct;58(10):753-5. PMID: 18983715 Abstract Title:  Dietary garlic and onion reduce the incidence of atherogenic diet-induced cholesterol gallstones in experimental mice. Abstract:  Mice fed with diet containing 0.5 % cholesterol for 10 weeks resulted in cholesterol supersaturation in gallbladder bile which promoted the formation of cholesterol gallstones (CGS). In this study, dietary hypocholesterolaemic spices, garlic and onion (both raw or heat-processed) were examined for their antilithogenic potential by including at 0.6 and 2.0 % level, respectively, along with lithogenic (LG) diet for 10 weeks. Dietary garlic and onion reduced the CGS incidence by 15-39 %, the effect being maximum in the heat-processed onion group. Dietary garlic and onion markedly reduced biliary cholesterol. The cholesterol:phospholipid ratio which was 1.58 in the LG diet group was reduced to 0.73-0.96 in the garlic and onion groups. The biliary cholesterol saturation index was 0.92, 1.25, 1.09 and 0.86, respectively, in the heat-processed onion, raw garlic, heat-processed garlic and raw onion groups, while it was 1.9 in the LG group. The hydrophobicity index of bile was - 0.08, - 0.079, - 0.032 and - 0.073, respectively, in the heat-processed onion, raw garlic, heat-processed garlic and raw onion groups, while it was +0.054 in the LG group. Hepatic hydroxymethyl glutaryl-CoA reductase activity was lowered in the LG diet-fed group, while dietary garlic or onion countered this alteration and also increased the activities of hepatic cholesterol 7 alpha-hydroxylase and sterol 27-hydroxylase. Serum and liver cholesterol were decreased by feeding garlic or onion compared to the LG diet. Thus, dietary Allium spices exerted antilithogenic influence by decreasing the cholesterol hyper-secretion into bile and increasing the bile acid output thus decreasing the formation of lithogenic bile in experimental mice. https://greenmedinfo.com/article/dietary-garlic-and-onion-reduce-incidence-diet-induced-cholesterol-gallstones-#comments Gallstones Garlic Onion Animal Study Thu, 16 Jul 2009 20:13:39 +0000 greenmedinfo 45596 at https://greenmedinfo.com Dietary garlic and onion regresses preestablished cholesterol gallstones in experimental mice. https://greenmedinfo.com/article/dietary-garlic-and-onion-regresses-preestablished-cholesterol-gallstones-exper PMID:  Metabolism. 2010 Feb 10. Epub 2010 Feb 10. PMID: 20153000 Abstract Title:  Regression of preestablished cholesterol gallstones by dietary garlic and onion in experimental mice. Abstract:  We have recently reported the health beneficial potential of dietary garlic and onion in reducing the incidence and severity of cholesterol gallstone (CGS) during its experimental induction in mice. In the current study, the efficacy of dietary garlic and onion in regressing preestablished CGS was investigated in experimental mice. After inducing CGS in mice with a lithogenic diet for 10 weeks, they were maintained on basal diets containing 0.6% dehydrated garlic or 2% dehydrated onion for a further 10 weeks. Dietary garlic and onion, either raw or heat processed, regressed preformed CGS in mice up to 53% to 59%, whereas the regression in the basal control diet group was only 10%. The antilithogenic potency of garlic was decreased by its heat processing, but not in the case of onion. Biliary cholesterol was significantly decreased in garlic- and onion-fed animals. Biliary cholesterol saturation index and hydrophobicity index were significantly lowered by dietary garlic and onion. Serum and liver cholesterol levels were decreased by feeding these spices during post-CGS induction period. Hepatic hydroxymethylglutaryl-coenzyme A reductase activity was increased after feeding garlic and onion, whereas activities of the cholesterol-degrading enzymes cholesterol-7alpha-hydroxylase and sterol-27-hydroxylase were increased in spice-fed groups. These results indicate that feeding garlic and onion effectively accelerates the regression of preformed CGS by promoting cholesterol desaturation in bile. This observation is significant in the context of evolving dietary intervention strategy to address regression of existing CGS and stopping the possible recurrence. https://greenmedinfo.com/article/dietary-garlic-and-onion-regresses-preestablished-cholesterol-gallstones-exper#comments Gallstones Garlic Onion Disease Regression Animal Study Tue, 23 Feb 2010 14:56:55 +0000 greenmedinfo 52362 at https://greenmedinfo.com EGCG reduces the susceptibility to cholesterol gallstone formation through the regulation of inflammation. https://greenmedinfo.com/article/egcg-reduces-susceptibility-cholesterol-gallstone-formation-through-regulation PMID:  Biomed Pharmacother. 2008 Dec;62(10):677-83. Epub 2008 Jan 30. PMID: 18374538 Abstract Title:  EGCG reducing the susceptibility to cholesterol gallstone formation through the regulation of inflammation. Abstract:  In order to investigate whether (-)-Epigallocatechin-3-gallate (EGCG) can reduce the susceptibility to cholesterol gallstone formation in vivo, cholesterol gallstones mouse model was established with lithogenic diet. Compared with the Model group, the administration of EGCG (40 mg kg(-1)d(-1) and 80 mg kg(-1)d(-1), i.g., respectively) significantly reduced the gallstone formation rates and the serum lipid levels, also maintained the body weight at a relatively low level. Results of the microarray profiling assay showed the anti-inflammation effect of EGCG underlying affecting the hepatic metabolic pathway of cholesterol. Additionally, the expression of nuclear factor-kappaB (NF-kappaB) was down-regulated and the expression of peroxisome proliferator activated receptor gamma (PPARgamma) was up-regulated after the treatment of EGCG. Also, the expression of CYP7A1 was up-regulated after the treatment of EGCG. In conclusion, the findings of this study implied that EGCG can effectively reduce the susceptibility to cholesterol gallstone formation through the regulation of inflammation. https://greenmedinfo.com/article/egcg-reduces-susceptibility-cholesterol-gallstone-formation-through-regulation#comments Cholecystitis EGCG (Epigallocatechin gallate) Gallbladder Inflammation Gallstones Animal Study Wed, 08 Jul 2009 20:59:51 +0000 greenmedinfo 45200 at https://greenmedinfo.com EPA prevents the formation of cholesterol gallstones in an animal model. https://greenmedinfo.com/article/epa-prevents-formation-cholesterol-gallstones-animal-model PMID:  Nippon Yakurigaku Zasshi. 1997 Oct;110 Suppl 1:50P-55P. PMID: 9503405 Abstract Title:  [Preventive effects of eicosapentaenoic acid (EPA) on cholesterol gallstone formation in hamsters]. Abstract:  Polyunsaturated fatty acids (PUFA) regulate various biological functions and are involved in a variety of diseases. Eicosapentaenoic acid (20:5, EPA), one of the omega-3 PUFA, has been reported a number of actions including suppression of platelet aggregability and decrease in serum lipids and is well known to be useful in preventing the atherosclerotic diseases. In this paper, we demonstrated that highly purified ethyl eicosapentaenoate (EPA-E) prevents cholesterol (CH) gallstone formation in hamster model. Repeated administration of EPA-E to animals fed a lithogenic diet for 6 weeks decreased the incidences of both CH crystal and CH gallstone formations in gallbladder bile. Contrary, bezafibrate, one of fibric acid derivative which were reported to increase CH saturation index (CSI) in bile, significantly increased the incidences of CH crystal and gallstone formations. EPA-E did not affect the CSI, but markedly increased biliary phospholipid concentration. In the same model, ethyl palmitate (16:0), ethyl oleate (18:1), ethyl linolate (18:2, omega-6) and ethyl arachidonate (20:4, omega-6) had no effects both on biliary lipids composition and CH gallstone formation. These result suggest the benefit of EPA-E in the prevention of CH gallstone. https://greenmedinfo.com/article/epa-prevents-formation-cholesterol-gallstones-animal-model#comments Cholestasis EPA (Eicosapentaenoic Acid) Gallstones Animal Study Thu, 16 Jul 2009 20:36:08 +0000 greenmedinfo 45599 at https://greenmedinfo.com Expectant management (i.e. doing nothing) of gallstone disease is a valid therapeutic approach in the majority of patients. https://greenmedinfo.com/article/expectant-management-ie-doing-nothing-gallstone-disease-valid-therapeutic-appr PMID:  J Gastroenterol Hepatol. 2010 Apr;25(4):719-24. PMID: 20492328 Abstract Title:  Natural history of gallstone disease: Expectant management or active treatment? Results from a population-based cohort study. Abstract:  BACKGROUND AND AIMS: The knowledge of natural history is essential for disease management. We evaluated the natural history (e.g. frequency and characteristics of symptoms and clinical outcome) of gallstones (GS) in a population-based cohort study.METHODS: A total of 11 229 subjects (6610 men, 4619 women, age-range: 29-69 years, mean age: 48 years) were studied. At ultrasonography, GS were present in 856 subjects (338 men, 455 women) (7.1%). GS were followed by means of a questionnaire inquiring about the characteristics of specific biliary symptoms.RESULTS: At enrollment, 580 (73.1%) patients were asymptomatic, 94 (11.8%) had mild symptoms and 119 (15.1%) had severe symptoms. GS patients were followed up for a mean period of 8.7 years; 63 subjects (7.3%) were lost to follow up. At the end of the follow up, of the asymptomatic subjects, 453 (78.1%) remained asymptomatic; 61 (10.5%) developed mild symptoms and 66 (11.4%) developed severe symptoms. In subjects with mild symptoms, the symptoms disappeared in 55 (58.5%), became severe in 23 (24.5%), remained stable in 16 (17%); in subjects with severe symptoms, the symptoms disappeared in 62 (52.1%), became mild in 20 (16.8%) and remained stable in 37 (31.1%). A total of 189 cholecystectomies were performed: 41.3% on asymptomatic patients, 17.4% on patients with mild symptoms and 41.3% on patients with severe symptoms.CONCLUSIONS: This study indicates that: (i) asymptomatic and symptomatic GS patients have a benign natural history; (ii) the majority of GS patients with severe or mild symptoms will no longer experience biliary pain; and (iii) a significant proportion of cholecystectomies are performed in asymptomatic patients. Expectant management still represents a valid therapeutic approach in the majority of patients. https://greenmedinfo.com/article/expectant-management-ie-doing-nothing-gallstone-disease-valid-therapeutic-appr#comments Cholecystectomy Gallbladder Surgery: Removal Gallstones Doing Nothing Surgical Procedures Watchful Waiting Meta Analysis Wed, 02 Feb 2011 21:24:06 +0000 greenmedinfo 60713 at https://greenmedinfo.com Fish oil fatty acids reduce the cholesterol saturation index and nucleation time in obese subjects, which probably result in prevention of gallstone formation. https://greenmedinfo.com/article/fish-oil-fatty-acids-reduce-cholesterol-saturation-index-and-nucleation-time-o PMID:  Appl Ergon. 2009 Nov;40(6):1047-54. Epub 2009 Jun 21. PMID: 11533270 Abstract Title:  Fish oil (n-3) polyunsaturated fatty acids beneficially affect biliary cholesterol nucleation time in obese women losing weight. Abstract:  It has been reported that intake of (n-3) polyunsaturated fatty acids (PUFA) reduces the risk of coronary heart disease and decreases biliary cholesterol saturation in the bile of gallstone patients. We investigated the effect of n-3 PUFA on cholesterol saturation index (CSI) and nucleation time (NT) in obese subjects who were losing weight. This was a double-blind, placebo-controlled clinical trial. Obese women (n = 35) with a body mass index (BMI) &gt; or = 30 kg/m(2), with no prior history of gallstones or cholecystectomy by ultrasound were first studied to ensure absence of stones or biliary sludge. The women were then assigned to a hypocaloric regimen [5.02 MJ (1200 kcal)/d] and to receive 1200 mg/d of ursodeoxycholic acid (UDCA), 11.3 g/d of (n-3) PUFA or a placebo for 6 wk. BMI, CSI and NT were recorded at baseline and at the end of the experimental period. BMI decreased 5.75 +/- 2.7%/mo (range, 1.5-12.42%/mo) during the experiment. The CSI did not change in any of the groups. Cholesterol NT decreased significantly in the UDCA and placebo groups, but not in the (n-3) PUFA group. None of the women had developed gallstones at 6 wk. These results suggest that (n-3) PUFA maintain the CSI and NT in obese women during rapid weight loss, which probably results in the prevention of cholesterol gallstone formation. https://greenmedinfo.com/article/fish-oil-fatty-acids-reduce-cholesterol-saturation-index-and-nucleation-time-o#comments Fish Oil Gallstones Human Study Thu, 16 Jul 2009 20:25:30 +0000 greenmedinfo 45597 at https://greenmedinfo.com