Symptomatic and silent gall stones in the community.

Heaton, K W; Braddon, Fem; Mountford, R G; Hughes, Andrew; Emmett, Pauline M

doi:10.1136/gut.32.3.316

Cited by 201 publications

(118 citation statements)

References 29 publications

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“…30 The prevalence of gallstone disease, prevalent gallstones and postcholecystectomy combined, was similar to that reported elsewhere in Japan; 31 the prevalence was 2.7% for men aged in their 50s in that study. However, these Japanese ®gures were much lower than those reported for men aged 50s or early 50s in Western populations; the prevalence rates for gallstone disease were 6.7% in Denmark, 32 24.5% in Norway, 33 7.5% in Britain 34 and 10.0% in Italy. 35 In summary, based on a large number of middleaged men screened by gallbladder ultrasonography, the present study showed a positive association for BMI and WHR each with prevalent gallstones and postcholecystectomy, and indicate that obesity enhances gallstone formation in men as well.…”

Section: Gallstone Risk In Japanese Men H Kodama Et Almentioning

confidence: 73%

Gallstone disease risk in relation to body mass index and waist-to-hip ratio in Japanese men

et al. 1999

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OBJECTIVE: To examine the relation of body mass index (BMI) and waist-to-hip ratio (WHR) to gallstones and postcholecystectomy risk in middle-aged Japanese men. DESIGN: Cross-sectional study. SUBJECTS: We used 174 men with prevalent gallstones, 104 with postcholecystectomy and 6909 with normal gallbladder in the consecutive series of 7637 men aged 48 ± 59 y receiving a preretirement health examination at four hospitals of the Japan Self-Defense Forces between 1986 and 1994. MEASUREMENTS: Gallbladder status was assessed by abdominal ultrasonography after an overnight fast. BMI was calculated as weight in kilogram divided by height in square meters, and WHR was used as a measure of central obesity. Analysis of the WHR was limited to a subset of data for the period 1991 ± 1994 (gallstones 113, postcholecystectomy 66 and normal gallbladder 4410). RESULTS: After adjustment for hospital, rank in the Self-Defense Forces, cigarette smoking, alcohol use and glucose tolerance, BMI was signi®cantly associated with an increased risk of both prevalent gallstones and postcholecystectomy. WHR also showed a signi®cant positive association with each of the two conditions. When BMI and WHR were mutually adjusted for, both of the obesity indices tended to be associated positively with prevalent gallstones and postcholecystectomy. CONCLUSION: These ®ndings indicate that obesity is associated with increased gallstone risk in men.

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Section: Gallstone Risk In Japanese Men H Kodama Et Almentioning

confidence: 73%

Gallstone disease risk in relation to body mass index and waist-to-hip ratio in Japanese men

et al. 1999

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“…2 In part, these contradictory findings are related to differences in research design. Some studies are uncontrolled, [13][14][15] other reports present findings from patients seeking medical care, [16][17][18] from case-control studies, 15,[19][20][21] or from community-based studies on selected [22][23][24][25][26][27] or unselected [28][29][30][31] populations. A recent meta-analysis, which takes into account all the studies issued on this topic from 1983 to 1992, concludes that only upper abdominal pain (with no preference for the right side)…”

Section: Discussionmentioning

confidence: 99%

Clinical manifestations of gallstone disease: Evidence from the multicenter Italian study on cholelithiasis (MICOL)

et al. 1999

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Despite the many efforts to delineate the clinical manifestations of gallbladder disease, the precise symptom complex associated with gallstones is still a matter of debate, and even the existence of gallstone-specific symptoms has been questioned. We carried out a large population-based cross-sectional study (MICOL) to identify symptoms significantly related to gallstones. Fourteen centers throughout Italy enrolled 29,504 subjects aged 30 to 69 years. All subjects were administered an ultrasonographic examination of the upper abdomen and a precoded questionnaire. All subjects were divided into 4 groups: 25,374 (86.0%) gallstone-free subjects (GF), 1,832 (6.2%) patients with gallstones not previously diagnosed (GNPD), 638 (2.2%) patients with gallstones previously diagnosed (GPD), 1,660 (5.6%) patients with a history of cholecystectomy for gallstones (CC). In logistic regression analysis, pain at epigastrium and, even more, pain at right hypocondrium were significantly associated with gallstones. For pain at right hypocondrium, this association progressively increased from GNPD (OR ‫؍‬ 1.60, 95% CI ‫؍‬ 0.97-2.65) to GPD (OR ‫؍‬ 8.77, 95% CI ‫؍‬ 5.27-14.61) to CC (OR ‫؍‬ 59.40, 95% CI ‫؍‬ 43.87-80.42). Absence of heartburn combined with right hypocondrium or epigastrium pain and intolerance to fried or fatty food were also significantly related to gallstones. We also found some pain characteristics significantly associated with gallstones, i.e., pain radiated to the right shoulder, forcing the patient to rest, occurring soon after meals or unrelated to meals, not relieved by bowel movements, and frequently accompanied by gallstonerelated morbidities. We developed a probability tree reporting the cumulative probability of having gallstones for each combination of those symptoms and characteristics of pain significantly associated with gallstones. In conclusion, we have identified symptoms and signs significantly associated with gallstones. We have shown that there is an increase in frequency and severity of these symptoms and signs across the different stages of gallstone disease. We have proposed a complex of symptoms and signs significantly associated with gallstones that might help physicians in clinical decision making. (HEPATOLOGY 1999;30:839-846.)Despite the many efforts to delineate the clinical manifestations of gallbladder disease, the precise symptom complex associated with gallstones is still a matter of debate, and even the existence of gallstone-specific symptoms has been questioned. 1-3 Most of the attention has been focused on pain in gallstone patients, but there is no general agreement on its clinical meaning 3 and it is questioned whether pain occurs in gallstone disease with specific characteristics. 1,2 The identification of symptoms associated with this disease might help physicians in clinical decision making. [4][5][6][7] Moreover, the possibility of identifying patients who are more likely to have gallstones through a clinical assessment would limit the excessive and inappropriate use of di...

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“…7 In western countries 10-12% of adults develop gallstones. [8][9][10] The pathogenesis of gallstones is complex process involving factors affecting bile content and bile flow. A crucial factor in the forming of bile duct stones is biliary stasis, which may be caused by sphincter of oddi stenosis, dyskinesia, or bile duct strictures.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of previously undiagnosed hypothyroidism in patients with cholelithiasis in a tertiary care center, North-East India

et al. 2017

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Background: Earlier, the studies had an increased prevalence of previously diagnosed hypothyroidism in gallstone patient and recent studies also demonstrated low bile flow in hypothyroid subjects or the sphincter of oddi expresses thyroid hormone receptors and thyroxin has a direct prorelaxing effect on the sphincter. Iceberg of hypothyroidism was present in cholelithiasis patients. The objective of this study was to find out the prevalence of previously undiagnosed hypothyroidism in cholelithiasis patients.Methods: A prospective study was conducted in the 500 consecutive patients with cholelithiasis between 1st October 2014 and 31st March 2016 to find relation between gallstone and hypothyroidism. Patients already diagnosed as hypothyroidism were excluded. In each patients, detailed history and clinical examination was done and sent for ultrasound of neck for goitre detection and laboratory Thyroid hormone assay (S-FT3, S-FT4 and S-TSH).Results: A total of 2.2%, 5.0% and 6.6% (total 13.8%, 69 of 500) of the cholelithiasis patients were diagnosed to have clinical, subclinical and borderline subclinical hypothyroidism. In women older than 50 year, the prevalence of clinical and subclinical plus borderline-hypothyroidism was 6.8% and 25.6% (11.7%±13.9%) and clinical plus subclinical plus borderline-subclinical hypothyroidism was 32.4% in cholelithiasis patients.Conclusions: Although a low prevalence of hypothyroidism was found in this study, but it is evident that subclinical and borderline subclinical hypothyroidism were significantly more common, compared with the clinical hypothyroidism and with increasing age there was increase in its prevalence, so we recommend that S-TSH level should be measured for every patient with cholelithiasis older than 50 years.

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Symptomatic and silent gall stones in the community.

Cited by 201 publications

References 29 publications

Gallstone disease risk in relation to body mass index and waist-to-hip ratio in Japanese men

Gallstone disease risk in relation to body mass index and waist-to-hip ratio in Japanese men

Clinical manifestations of gallstone disease: Evidence from the multicenter Italian study on cholelithiasis (MICOL)

Prevalence of previously undiagnosed hypothyroidism in patients with cholelithiasis in a tertiary care center, North-East India

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