Gallbladder concentrates bile formed in the liver and stores it until needed for digestion of fat. The entrance of fat in the duodenum
stimulates the secretion of the hormone cholecystokinin by the
intestinal mucosa. This hormone reaches the gall bladder via the blood
and causes it to contract releasing bile. Interference with the flow of
bile may cause impaired fat digestion.
the inflammation of the gall bladder usually due to a low grade chronic
infection. Such a infection affects the absorptive powers of the gall
bladder mucosa, in turn affecting the solubility ratios of the bile
ingredients. Thus, cholesterol may precipitate out causing gall stones
to form. Gallstone formation or cholethiasis may occur when along with cholesterol bipigments, bile salts, calcium and other substances
precipitate out of the bile.
Factors leading to
- High dietary fat intake
over a long period of time predisposes to gallstone formation because
of constant stimulus to produce more cholesterol as a bile ingredient
to metabolize fat
The main aim of dietary
treatment is to reduce discomfort by providing a diet restricted in fat.
In acute cases, it is advisable to keep the gall bladder at rest and minimize
contractions. Thus fat is excluded from the diet.
A liquid diet, given as
hourly or two hourly feeds daily for a few days, would be beneficial.
When the condition settles down, clear soups. weak tea milk, refined
cereals may be added
disease is more prevalent in communities consuming significantly more
calories. The minimum amount of calories to maintain normal bodyweight
is therefore advised.
intake also increases biliary cholesterol concentration. A normal 60 to
80 grams of protein intake is permitted.
Since the fat is
the major cause of pain, the energy needs should mainly be met from
carbohydrates and not fat sources. The fat intake may be limited to 20
to 30 g per day and later increased to 40 to 45 g per day, thus
increasing the palatability of the diet. Control of fat also contributes
For patients in whom fats do not produce symptoms, administration of
vegetable oils like olive oil and unhydrogenated ground nut or till oil
of simple sugars in drinks and sweets is associated with gallstone
intake is also considered as a cause of gallstone formation, but fiber
has been shown to have very little effect on cholesterol metabolism
If a low fat diet is prescribed, fat soluble vitamins A, D, E and K
should be given as supplements
A high fluid intake should be encouraged
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