Gallstones in the family

We know that the risk of developing gallstones has a strong genetic component.

We know this (among other ways) from twin studies, pairs of  identical twins (who share all their genes) are more likely to both have (or both be free of) gallstones, than pairs of non-identical twins.

Indeed the rate in non-identical twins is the same as the rate in normal siblings, suggesting genes are important, early environment is not important or much less important as regards gallstones.

Unsurprisingly then we find that if a first degree relative (father, mother, sister, brother) has gallstones, your risk of developing them is increased, as you likely share some of the genes they have that predispose them to gallbladder diseases. Roughly the risk is doubled, from ~10% to ~20%. Correspondingly it follows that if no one in your family has had gallbladder issues your risk must be less that 10%.

I noted in my reading also that inflammatory bowel disorders, such as Crohns’ disease) that affect the ileum (last few meters of the small intestine), can prevent re-absorption of bile salts, and thus lead to a propensity to develop gallstones.

The research on risk factors notes age (older people get more gallstone – no one is surprised by this), gender (women at more likely to get them), obesity (fat people are more likely to get them). Losing weight fast, and low cholesterol can also risk factors for gallstones.

The research on gallbladders is no where near what I expected in terms of quality given how common a disorder it is. I guess since an effective treatment exists, and that even if one correctly predicts the occurrence of gallstones in an individual they are often asymptomatic, so correctly  predicting gallstones themselves  is probably not useful to doctors other than for patient education.

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