Gallstone Risk Higher Among Obese Children And Teenagers

Date: Aug-27-2012Obese and overweight children or teenagers have a considerably higher risk of developing gallstones compared to their peers of normal weight, researchers from Kaiser Permanente, USA, reported in the Journal of Pediatric Gastroenterology & Nutrition. Gallstones are not usually seen in kids, the researchers added.

The authors found that, compared to children and teenagers of normal weight, the risk of developing gallstones was:
Six times as high among extremely obese teenagers and children
Four times as high among moderately obese teenagers and children
Twice as high among overweight teenagers and children

The USA has a very high incidence of gallstone disease; public health officials say it is a major health problem for the country. According to the CDC (Centers for Disease Control and Prevention), about 20 million American adults are estimated to have gallstone disease.

Corinna Koebnick, PhD, and team gathered data from the electronic records of over 510,000 kids aged from 10 to 19 years from 2007 to the end of 2009; they were all members of Kaiser Permanente Southern California.

The sample population they studied was large and diverse enough to consider ethnic and racial disparities, the authors explained. Hispanic teenagers and children appear to have the highest risk of developing gallstones in that age group.

Dr. Koebnick said:

"Although gallstones are relatively common in obese adults, gallstones in children and adolescents have been historically rare.

These findings add to an alarming trend - youth who are obese or extremely obese are more likely to have diseases we normally think of as adult conditions."

The link between overweight/obesity and gallstone risk was particularly noticeable in girls. Obese and extremely obese girls were found to have a 6 to 8 times greater risk respectively, compared to their counterparts of normal weight. Obese boys had twice the risk, while for severely obese boys there was a three times higher risk.

Senior study author, George Longstreth, MD., said:

"The high rate of gallstones in obese children and adolescents may surprise pediatricians because gallstone disease is generally regarded as an adult disorder. Since obesity is so common, pediatricians must learn to recognize the characteristic symptoms of gallstones."

Koebnick added "With increasing numbers of cases of gallstones in children, we wanted to better understand the potential role of risk factors such as obesity, gender, ethnicity, and oral contraceptive use. With childhood obesity on the rise, pediatricians can expect to diagnose and treat an increasing number of children affected by gallstone disease. It is important to identify other factors that increase risk as well."

The database revealed that in southern California, 5.5% of girls up to the age of 19 years and 7.3% of boys are extremely obese.
What are gallstones?

The gallbladder stores gall (bile). Gall goes through the bile duct to the small intestine, where it aids digestion
Gallstones are stones or lumps that develop and accumulate in the bile duct or gallbladder.

The gallbladder, a small sac, is located on the underside of the liver, on the right-hand side of the body. The liver produces a greenish-brown liquid called bile (gall). Gall is stored in the gallbladder. Gall facilitates the digestion of mainly fats; it enters the small intestine via the bile ducts.

Cholesterol, calcium carbonate, and calcium bilirubinate may sometimes harden into several small stones or one large one. The main type of gallstones in the USA and UK are caused by too much cholesterol in the bile.

Most people with gallstones report no symptoms; they remain in the gallbladder and cause no problems. Sometimes the gallbladder may become inflamed (cholecystitis), and the following signs and symptoms may be present:
A pain just below the ribs, on the right side of the body
Restlessness
Sweating
Vomiting
Back pain
Shoulder pain (on the right side)
Biliary colic - a painful condition. This occurs when the gallstones make their way through the bile duct into the duodenum. The upper part of the abdomen is painful. Some people experience pain in the center of the abdomen, or slightly to the right. Typically, the pain is worse about one hour after having a meal, and then it subsides. In some cases the pain is persistent.
Gallbladder infection - the patient will have a fever and may shiver. In most cases, they will be admitted to hospital and have the gallstones removed.
Jaundice - the skin, tongue, and the whites of the eyes take on a yellowish color. Sometimes the gallstone may get stuck in the bile duct, blocking the intestine's supply of gall (bile). The bile makes its way into the bloodstream, resulting in jaundice-like symptoms. In most cases, the gallstones will have to be surgically removed. Some patients though, may not have to undergo surgery because the gallstones eventually pass into the intestine.
Pancreatitis - the gallstones may go through the bile duct and block the pancreatic duct; it may also cause bile to reflux, resulting in pancreatitis.

Written by Christian Nordqvist

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