How can I avoid getting gallbladder stones
Diet tips against gallstones
The gastroenterologist went on to explain that the interaction of the three main components of bile is also changed by various drugs: fibrates and somatostatin analogues inhibit the key enzyme for the synthesis of bile salts, which shifts the balance with fewer bile salts so that crystals precipitate . During fibrate therapy, more cholesterol accumulates in the bile, which further promotes the formation of gallstones.
Why women get significantly more gallstones is now also better understood, said Donner: The female hormone estradiol is absorbed into the liver cell, conjugated there and excreted in the bile. In the bile duct, conjugated estradiol can inhibit the transporters of bile salts and thus slow down the transport of the bile. If tiny mutations of the salt transporter are added, the interaction of the components of the bile juice is also disturbed and the risk of stone formation increases. An increased formation of gallstones was observed both under oral contraceptives and under postmenopausal hormone therapy, emphasized Donner.
Avoid being overweight and starving
In addition to gender, age, ethnicity, and family history, lifestyle also affects the formation of gallstones. Obese people are more likely to develop gallstones because they secrete twice as much cholesterol in the bile as people of normal weight, which changes the solubility ratios. In addition, the motility of the gallbladder decreases significantly in overweight people.
A reduced ability to contract the gallbladder favors the formation of stones because the bile stays in the gallbladder longer. Long periods of hunger can therefore be problematic, as less bile is required and the motility of the gallbladder decreases. Parenteral nutrition also increases the risk of gallstone disease.
Lots of fiber, little sugar
The diet also offers patients with a family history of gallstones many starting points for modifying the risk, Donner said. High-calorie and low-fiber foods increase the risk. A high fiber intake, on the other hand, promotes intestinal transit and reduces the resorption of bile salts. A daily intake of around 24 grams of fiber reduces the relative risk of gallstones by around 13 percent. Donner assessed a diet that contained many mono- and disaccharides as critical with regard to the formation of gallstones. Then more insulin is formed, which can heat up the hepatic cholesterol formation. The gastroenterologist conducted a study with 290 patients who were divided into four quartiles depending on their sugar consumption. It showed that the participants in the group with the highest sugar consumption also developed the most gallstones. For every 40 grams of sugar per day, the gallstone risk doubles, Donner reported. This explains why type 2 diabetics are also among the risk groups for gallstones.
There are currently contradicting data on total fat intake, so that no recommendations can be derived from them. At least 15 grams of fat per day are necessary to trigger a contraction of the gallbladder, added Professor Dr. Werner Richter from the Institute for Lipid Metabolism and Hemorheology in Windach. This fat consumption can prevent microcrystallization from occurring.
Overall, omega-3 fatty acids have a beneficial effect on the secretion of cholesterol in the bile. This is confirmed by a study with almost 300 gallstone patients who received 4 grams of omega-3 fatty acids over a period of three weeks. However, a prospective long-term study is not yet available, said Donner.
Donner and Richter could not confirm the common assumption that insufficient fluid intake also increases the risk of gallstones. Vitamin C plays an interesting role, Donner emphasized, as it stimulates the key enzyme in bile salt synthesis. A beneficial effect from increased vitamin C intake is theoretically plausible, but so far there have been no prospective studies on this. With the increasing molecular understanding of the pathogenesis of gallstones, it will also be possible to better assess the influence of the individual food components in the next few years, Donner hopes.
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