Upper abdominal pain? Could be gallstones! In recent years, due to the westernization of Chinese people's eating habits, the intake of high-fat, high-calorie and high-cholesterol diets has increased, so the common types of gallstones in Taiwan Province Province have gradually changed from "pigment stones" to "cholesterol stones". Therefore, this paper mainly studies the common cholesterol stones.
There are many reasons for gallstones. In earlier years, "gallstones with pigment" were the most common in Taiwan Province Province, and some of them were thought to be related to hemolytic anemia. The rest is due to the shortage of materials in early Taiwan Province Province, which makes people more vulnerable to malnutrition, parasites and infectious diseases, thus increasing the chance of gallstones. In western countries, more than 80% of patients are "cholesterol stones". In recent years, people's eating habits in Taiwan Province Province have changed, and most of them are "cholesterol stones".
Regarding the causes of cholesterol gallstones, Zheng Naiyuan, dean of Lian 'an Clinic, a preventive medical institution in Lian 'an, said that cholesterol gallstones are mainly due to the loss of solubility of chemical components in bile. When the cholesterol in bile is too high and the concentration is too saturated, it will precipitate into crystals, and after a long period of accumulation, it will gradually form larger cholesterol stones.
Could be gallstones. Where will gallstones occur?
1 The gallbladder is like a small reservoir, which is mainly responsible for temporarily storing bile. However, if you don't eat for a long time, you don't need bile to participate in digestion. At this time, the sphincter at the outlet of the bile duct will contract, so that bile cannot enter the intestine. The increased pressure in the bile duct will cause bile to return to the gallbladder, where it will accumulate and concentrate. If the cholesterol in bile is supersaturated, it will gradually accumulate from small crystals into large gallstones. Fortunately, the gallbladder space is large and bile is liquid. As long as most gallstones in the gallbladder do not fall to other parts, they will not endanger health in principle.
Biliary duct and cholelithiasis in bile duct partly fall from gallbladder, and a small part is generated in bile duct. The common causes are: bile flow is not smooth, bile duct has been blocked or infected and inflamed, congenital bile duct abnormality, duodenal diverticulum pressing the bile duct. The accommodation space and outlet in the bile duct are narrow, and a little stone is easy to cause obstruction, even inflammation or bacterial infection; Furthermore, bile duct and pancreas are open. Once bile duct and pancreatic duct are blocked at the same time, it is easy to be complicated with acute pancreatitis, which increases the difficulty of treatment. Therefore, if you find gallstones in the bile duct, you should follow the doctor's advice and consider further treatment.
The main site of hepatolithiasis is gallbladder, followed by bile duct, but the incidence of hepatolithiasis in Asians is slightly higher than that in other regions. Therefore, hepatolithiasis used to be called "Oriental Gallstones".
Maybe it's gallstones. After understanding the causes and locations of gallstones, we will further explain the high-risk groups and causes of gallstones:
According to statistics, the probability of women suffering from gallstones is slightly higher than that of men, and obese women need more attention.
The proportion of gallstones will gradually increase with age, generally 50 ~ 60 years old, but in recent years, young and middle-aged patients have also increased.
Different races have different types of gallstones. For example, in the past, 75% Indians in the United States suffered from gallstones, with a very high proportion.
Inheritance of family history is also one of the common factors of gallstones, mainly because of the influence of genes, more cholesterol is discharged into bile, and bile is too thick to form gallstones.
Obese obese people (body mass index, waist circumference, etc. The risk of gallstones is several times that of ordinary people. Some experts even believe that cholesterol gallstones and fatty liver are also one of the manifestations of metabolic syndrome, which shows that obesity involves a wide range of health.
Maybe it's gallstones Statistics show that women who have given birth many times are more likely to suffer from gallstones than women who have not given birth at all. It is speculated that it is related to the surge of hormones (estrogen and lutein hormone) during pregnancy. Zheng Dean milk source reminds that it will be more difficult to treat gallstones-related diseases during pregnancy. Fortunately, there are few seizures in clinic, so pregnant mothers don't have to be overly nervous.
Eating high-cholesterol foods & sweets like eating high-cholesterol foods such as animal viscera, fat meat, egg yolk and shelled seafood, which easily leads to high cholesterol concentration in blood and bile; Excessive sugar intake will lead to a rapid increase in blood sugar and insulin secretion and an accelerated accumulation of cholesterol. When the bile in the body is too thick and saturated, it will crystallize and precipitate, which will calcify into stones in the long run.
If the drug itself reacts violently to hormones, long-term use of contraceptives or hormone replacement therapy may lead to an increase in the probability of gallstones. It can be seen that female hormones have always played a key role in regulating cholesterol in the body.
Surgery, early gastrectomy or vagotomy will indirectly affect the emptying ability of gallbladder.
Zheng Dean Naiyuan reminded that "high cholesterol in blood" and "high cholesterol in bile" are actually two ends of a seesaw-a German research report pointed out that higher cholesterol in blood means less cholesterol in bile, but it is less likely to form gallstones, but the detailed causal mechanism is not very clear.
Women are slightly more likely to have gallstones than men.
Maybe gallstones are the cause of gallstones. Can gallstones lead to life-threatening? The discomfort caused by gallstones often manifests as acute symptoms such as severe abdominal pain, jaundice and fever, among which the problem of "infection" is the most worrying. For example, if gallstones block the gallbladder and cause inflammation, it may lead to gangrene or rupture, further bacterial infection, and even pancreatic inflammation (according to statistics, the two main causes of pancreatic inflammation are "gallstones" and "excessive drinking"). These released undesirable substances flow into the systemic circulation with blood, and may also cause pathological changes or failure of other organs. Fortunately, such a serious situation is not common.
Treatment: Cholecystectomy is the most radical method, including traditional open surgery and endoscopic cholecystectomy. In addition, endoscopy, choledochotomy and drug dissolution can also be used as appropriate. If the doctor evaluates that it is necessary to remove the gallbladder, it may have a slight impact on health-bile mainly plays the role of emulsifying fat, and fat can only react with enzymes in the body if it is dissolved in water. Without the gallbladder, it is like the lack of a reservoir, but the body still retains the ability to make bile. There will be some discomfort such as indigestion, diarrhea and flatulence in the transition period after operation, and it will gradually return to normal after a period of adjustment. Zheng Dean Naiyuan mentioned that preventive cholecystectomy was often taken decades ago, but it was later overturned by large-scale research. At present, it is suggested that most patients should be followed up regularly, and if they have discomfort or other doubts, they should consider removing their gallbladder.
Speaking of stones, we often hear about the treatment of extracorporeal shock wave lithotripsy, but extracorporeal shock wave lithotripsy is mainly used to treat kidney calculi, because the space in the gallbladder is not as tight as kidney tissue, so it is difficult for shock waves to hit stones accurately, and even if the lithotripsy is successful, how to expel the fragments from the body is still a great test.
Could be gallstones. Reject gallstones. You should eat like this. Whether you are a high-risk group suffering from gallstones or a confirmed gallstone patient, everyone should follow the dietary principle of "low sugar, low fat, low cholesterol and high fiber", which is a healthy concept. To reject gallstones from food, you can also pay attention to the following dietary points:
Eating more is a good helper to lower cholesterol.
(1) Oats: Oats contain water-soluble dietary fiber "β-polyglucose", which can prevent the intestinal tract from absorbing cholesterol and change the concentration of fatty acids in the blood.
(2) Nuts: Nuts are rich in polyunsaturated fatty acids, which help to lower cholesterol and maintain arterial elasticity. But nuts are high-calorie oils, and should not exceed 65,438+00g per day.
(3) Fish containing Omega-3: Omega-3 can lower blood pressure and triglycerides, and also increase the content of beneficial high-density cholesterol (HDL) in blood. It is suggested that tuna, sardines, mackerel and other fish rich in Omega-3 can be eaten at ordinary times.
High cholesterol foods stop.
(1) Egg yolk: Eggs are rich in nutritional value, but one egg yolk contains about 270 mg of cholesterol, which is close to the recommended intake of cholesterol for one day. Therefore, except for developing children, healthy adults are advised not to eat more than/kloc-0 eggs a day, and people with cholesterol problems should control no more than 3 eggs a week.
(2) Seafood: All animal foods contain cholesterol, but squid, cuttlefish, shrimp and other seafood have high cholesterol content, reminding you that if you are used to eating big fish and big meat but rarely eat vegetables, if your cholesterol is too high, you may quietly come to your door.
(3) Others: Other foods, such as fat with skin, animal offal, butter and cream, also contain high cholesterol.
Vegetarians have fewer gallstones. Vegetarians have less exposure to animal fats and unsaturated fats. Eating a lot of high-fiber fruits and vegetables can not only help gastrointestinal peristalsis, but also intercept cholesterol discharged with bile in the intestine and reduce the cholesterol concentration in bile. Therefore, vegetarians are less troubled by cholesterol stones.
Maybe gallstones caused you to eat less oil. Zheng Dean milk sources suggest that you can choose edible oils containing monounsaturated or polyunsaturated fatty acids such as olive oil, sunflower oil and mustard oil, or occasionally supplement fish oil rich in Omega-3, which can reduce the chance of cholesterol gallstones, and you can choose lean meat ingredients with less skin and less oil. In contrast, excessive intake of animal fat will promote the synthesis of cholesterol in the body, and coconut oil and lard with high saturated fat content should be avoided as much as possible.
Does olive oil+laxatives help to eliminate gallstones? Almost all patients with gallstones have heard of "olive oil+diarrhea brine", a folk prescription to help eliminate gallstones. Zheng Dean Naiyuan explained that many patients did try it, and told him that they would see many large or small crystalline substances in feces, which was evidence that gallstones were excreted. In fact, alkaline substances (laxatives) will saponify when they meet oil (olive oil), and the bile duct space is narrow, so it is almost impossible for stones to pass through the bile duct without discomfort, so most of these crystals are saponification products, not gallstones.
Moderate exercise can prevent the formation of gallstones. Many modern people have not developed the good habit of exercising because of their busy life and lack of space. However, exercise has many benefits to health, which can not only promote metabolism and reduce the incidence of cardiovascular diseases, but also help to reduce blood sugar, blood lipids and gallstones, and also reduce the probability of chronic diseases. It is recommended to do low-intensity aerobic exercise for about 30 minutes at least three times a week, which is very helpful to the body.
Perhaps gallstones caused it to improve NG's living habits.
NG 1 Don't eat bile in the gallbladder for breakfast, and regularly enter the gastrointestinal tract to digest food three times a day. In other words, eating regularly helps the gallbladder to continue to store newly secreted bile after emptying, while skipping breakfast will continue to concentrate the bile accumulated overnight, supersaturating the cholesterol in the bile, which will easily lead to the formation of gallstones after a long time.
NG 2 diet, sometimes overeating and sometimes not eating, will lead to rapid contraction of gallbladder. If the gallbladder happens to have gallstones, it is likely to be pushed, gathered and blocked. Many patients with gallstones always have abdominal pain after dinner, often because most people like to eat and drink at dinner, and then suddenly have abdominal pain before going to bed. This kind of pain is more serious than indigestion and irritable bowel syndrome, but many people mistakenly think that eating too much leads to stomach pain without knowing it. The pain will last for more than 65,438+0 ~ 2 hours, and even the discomfort will gradually decrease after vomiting.
NG 3 fast dieting to lose weight Some people try to control their weight by fasting, or because of postoperative discomfort, long fasting time, excessive bile concentration but poor circulation, it will increase the chance of causing gallstones. Zheng Dean Naiyuan reminded that in addition to regular and quantitative diet, if you want to lose weight due to health factors, you'd better do more exercise instead of slimming on an empty stomach, so as to make your body healthier and more beautiful.
NG 4 likes snacks and sweets. Usually, the amount of refined sugar and sweets should be restrained, because the blood sugar will rise rapidly after excessive sugar intake, and a large amount of insulin will be secreted to accelerate the accumulation of cholesterol; In addition, you should also eat less food that is too fine, such as white rice and noodles (although it is too fine and easy to digest, it will quickly break down into sugar). It is suggested to eat more whole grains, which are not only rich in vitamins and minerals, but also can get more dietary fiber from them.
Zheng Naiyuan Education: Faculty of Medicine, Gao Xue Medical University, First Department of Internal Medicine, National Yamaguchi University. Experience: Director of General Internal Medicine and Director of Internal Medicine of Renai Hospital, Director of Ultrasound Department of Renai Hospital, and attending physician of Gastroenterology Department of Renai Hospital. Current position: Dean of Lian 'an Clinic, a preventive medical institution in Lian 'an.