Friday, 1 July 2016

Causes of gallstones among Africans and how to prevent it- Expert

Gallstones are one of the most prevalent diseases affecting the gastrointestinal tract.

Gallstones were once associated with older people but nowadays, younger people are developing gallstones due to poor dietary and stressed life style.

The prevalence of gallstone is lower in Africans than in people from the western world. Approximately, one in two Americans have gallstones and 750,000 will have their gallstones removed by year-end. This difference is attributed to differences in dietary cholesterol and or fibres in diet. This is attributed to differences in dietary cholesterol and or fibres in diet.

When we cook in Africa, it is typical to have either palm or vegetable oil flowing at the top of the stew. Furthermore, the oil we commonly use in cooking has 100 per cent saturated fat content. In general, the average daily requirement for oil in cooking is about two to three tablespoonfuls.

Gallstones are crystal-like masses formed within the gall bladder by the accumulation of bile components. Sizes range from a grain of sand to 3-4cm. The gall bladder is a small organ located on the right side of the liver, attached to the common bile duct. Its main function is to store bile (produced by the liver) and secretes it into the small intestine for the digestion of fat.

Gallstone is formed because of precipitation of cholesterol and bile salts from the bile.

There are three types of gallstones -Cholesterol stones (yellow-green and made primarily of hardened cholesterol).

-Pigment stones (dark stones develop in people with pre existing condition like sickle cell, cirrhosis, biliary tract infection).

-Mixed stones-the most common type.

The medical understanding of how gallstone develops is increasing. It is believed that gallstones may be caused by a combination of factors including hereditary, obesity, and the ability of the gall bladder to contract.

Risk factors that may lead to the formulation of gallstones include:

Gender: women between 20 and 60 years are twice likely to develop stones than men.

Increasing age over 60 years.

Ostrogen found in birth control pills, pregnant women and in hormone replacement therapy.


Fasting: This inhibits the gall bladders’ ability to contract causing high concentration of cholesterol build up in the bile.

Adult consuming diet high in fat and sugar along with inactive lifestyle.

Rapid weight loss and constipation. This is why any attempt to lose weight should be with proper medical supervision that ensures regular daily bowel movement.

Inadequacy of vitamins and minerals such as folic acid, magnesium, calcium and vitamin C.

E.coli infection: e.coli is a bacterium found within the colon and in stool. Research showed that many patients with pigments stones have large concentration of bacteria in their bile.

Roundworm infection: Over 70 per cent of patients with pigment gallstones have part of roundworm or their egg within the stones. The use of medications to remove worms at least once or twice a year will guard against this.

Liver cirrhosis. This is usually due to heavy alcohol consumption or infection. Heavy metal deposits in the body and food toxins may also be a predisposing factor to liver cirrhosis.

Sickle cell anaemia: Gallstones are common in sickle cell anaemia, according to national digestive diseases information clearing house. Sickle cell disease is a genetic disease that causes deformation of red blood cells. These deformed cells are broken down and release large amount of bilirubin, which accumulate in the gall bladder forming pigment stones.

The prevalence of gallstones reported in sickle cells disease (HbSS) has varied widely, from 34-70 per cent in the West Africa, 29 per cent in Jamaica, 4-25 per cent in Africa. This variability depends on age and sensitivity of diagnostic method.

Gallstones may be asymptomatic, even for years. These stones are called “silent stones” and do not require treatment. Symptoms begin to appear once the stone is greater than 8mm.

Symptoms of gallstones are similar to those of acute abdominal crisis in sickle cell anaemia, heart attack, appendicitis, ulcers, pancreatitis, and hepatitis so accurate diagnosis is important.

Symptoms occur because of a weak liver and congested gall bladder and may vary. It often follows a fatty meal and is worse at night. These include:

Abdominal bloating
Recurring intolerance to fatty food
Recurrent pain in the upper abdomen that increases rapidly and lasts from 30mins to several hours.
Pain in the back around the shoulder blade.
Pain under the right shoulder.
Nausea or vomiting
Indigestion and belching
Increase allergies
Depressed immune system
Increase desire for sugar.
Ultrasound is the most sensitive and specific test for gallstones.

Do you have similar condition and unsure of what to do, considering the cost of surgery and its possible complications? You can visit our website or you can reach us on +2348191908614 for more inquiries.

The Punch Columnist Prof.Oladapo Ashiru