Gallstone disease primary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Effective measures for the primary prevention of gallstone disease include diet with sufficient fat and protein, maintaining a low body weight, and avoiding prolonged fasting.
Primary Prevention
Patients at highest risk for developing gallstones are:
- Pregnant women
- Patients who rapidly lose weight or have undergone weightloss surgery
- Patients on long-term octreotide
- Patients on long-term total parenteral nutrition (TPN)
- Patients treated with Ceftriaxone[1][2]
Primary prevention measures
- Eat three meals daily containing sufficient fat or protein, high in fiber and calcium, and low in saturated fats
- Maintain a low body weight
- Regular exercise
- During pregancy maintain nutritional requirements
- Patients receiving total parenteral nutrition (TPN) should be periodically assessed for possible enteral feeding[3] [4]Closing
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References
- ↑ Maringhini A, Ciambra M, Baccelliere P, Raimondo M, Orlando A, Tinè F, Grasso R, Randazzo MA, Barresi L, Gullo D, Musico M, Pagliaro L (1993). "Biliary sludge and gallstones in pregnancy: incidence, risk factors, and natural history". Ann. Intern. Med. 119 (2): 116–20. PMID 8512160.
- ↑ Shiffman ML, Keith FB, Moore EW (1990). "Pathogenesis of ceftriaxone-associated biliary sludge. In vitro studies of calcium-ceftriaxone binding and solubility". Gastroenterology. 99 (6): 1772–8. PMID 2227290.
- ↑ Sitzmann JV, Pitt HA, Steinborn PA, Pasha ZR, Sanders RC (1990). "Cholecystokinin prevents parenteral nutrition induced biliary sludge in humans". Surg Gynecol Obstet. 170 (1): 25–31. PMID 2104681.
- ↑ Valdivieso V, Covarrubias C, Siegel F, Cruz F (1993). "Pregnancy and cholelithiasis: pathogenesis and natural course of gallstones diagnosed in early puerperium". Hepatology. 17 (1): 1–4. PMID 8423030.
- ↑ Leitzmann MF, Giovannucci EL, Rimm EB, Stampfer MJ, Spiegelman D, Wing AL, Willett WC (1998). "The relation of physical activity to risk for symptomatic gallstone disease in men". Ann. Intern. Med. 128 (6): 417–25. PMID 9499324.
- ↑ Marks JW, Stein T, Schoenfield LJ (1994). "Natural history and treatment with ursodiol of gallstones formed during rapid loss of weight in man". Dig. Dis. Sci. 39 (9): 1981–4. PMID 8082507.
- ↑ Shiffman ML, Sugerman HJ, Kellum JM, Brewer WH, Moore EW (1991). "Gallstone formation after rapid weight loss: a prospective study in patients undergoing gastric bypass surgery for treatment of morbid obesity". Am. J. Gastroenterol. 86 (8): 1000–5. PMID 1858735.
- ↑ Sugerman HJ, Brewer WH, Shiffman ML, Brolin RE, Fobi MA, Linner JH, MacDonald KG, MacGregor AM, Martin LF, Oram-Smith JC (1995). "A multicenter, placebo-controlled, randomized, double-blind, prospective trial of prophylactic ursodiol for the prevention of gallstone formation following gastric-bypass-induced rapid weight loss". Am. J. Surg. 169 (1): 91–6, discussion 96–7. PMID 7818005.