B Nejadnik and L Cheskin, Johns Hopkins
University, Baltimore, MD, USA
© 2005 Elsevier Ltd. All rights reserved.
The incidence of gall bladder disease in the United States exceeds 20 million cases annually. The total cost of gall bladder disease in the United States is more than that of any other gastrointestinal illness, including colorectal cancer and peptic ulcer disease.
Gall bladder disease has an intimate relationship with diet and nutrition. On the one hand, there has been a great deal of interest in the role of dietary constituents and nutritional habits in the etiology of gall bladder disease. On the other hand, an individual's nutritional status has a direct impact on the risk of acquiring gall stones. For instance, obesity as well as rapid weight loss and total parenteral nutrition (TPN) predispose the patient to a higher risk of gall bladder disease. Of course, there are multiple other risk factors that play an important role in the formation and manifestations of gall bladder disease, including female gender, family history of first-degree relative with gall stone disease, pregnancy, and drug use. Approximately three-fourths of gall stones detected in the general population are cholesterol gall stones.
According to a large study of the Danish population published in 1991, the 5-year incidence of gall stones in men and women aged 30 years was 0.3% and 1.4%, respectively. At age 60, the incidence had increased to 3.3% and 3.7% for men and women, respectively. It seems that the difference in incidence between men and women disappears with age. This may be related to the difference in estrogenic hormones between the two genders, which follows the same pattern.
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