Obesity is an important risk factor for gallstone disease, more so for women than for men. It raises the risk of cholesterol gallstones by increasing biliary secretion of cholesterol, as a result of an increase in 3-hydroxy-3-mthylglutaryl coenzyme A (HMGCoA) reductase activity. Epidemiological studies have found that the lithogenic risk of obesity is strongest in young women, and that slimness protects against cholelithiasis.
Obesity and rapid weight loss are major risk factors for the development of cholelithiasis (gallbladder stones). Patients after bariatric surgery are at an increased risk for gallstones formation and subsequent cholecystectomy. The risk of developing gallstones is from 20-30% during the first 6 months after surgery and about 20% the next 6 months with an incidence of 55.4% in total no matter which procedure you went through, but it is well known that is slightly more frequently in post Gastric By-Pass
Rapid weight loss is associated with occurrence of sludge and gallstones in 20-30% of patients in a few weeks of initiating the slimming procedures. If a person loses weight too quickly, the liver secretes extra cholesterol; in addition, there is rapid mobilization of cholesterol from adipose tissue stores. In fasting associated with severely fat restricted diets, gallbladder contraction is reduced, and the accompanying gallbladder stasis favors gallstone formation. Enhancing gallbladder emptying by inclusion of a small amount of dietary fat inhibits gallstone formation in patients undergoing rapid weight loss.
Fasting in the short term increases the cholesterol saturation of gallbladder bile and in the longer term, causes gallbladder stasis which can lead to sludge, and eventually gallstone formation.
Dr Luis Pasten recommends in a prophylaxis approach to remove the gallbladder at the same time that weight loss surgery is performed. Preventing the high probability of having to be intervened, because of gallstones interfering with the patients routine and the uncomfortable recovery time period. For a minimal additional cost. If there’s previous family members who have already suffered from gallstones you might consider on choosing this option as a form of prevention.
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Juárez, 22040 Tijuana, B.C.
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Dr. Luis Pasten.