Gallstone disease continues to be a major cause of illness and hospitalization in this twentieth century, with at least a fifth of men and a third of women predicted to develop gallstones in their lifetimes.
In fact, in most western countries, cholecystectomy or surgical removal, of the gallbladder is one of the most common operations performed in a hospital.
Unfortunately, we still do not know precisely why gallstones form, despite much research having gone into the subject.
We do know that vegetarians are less prone to this problem, and that the slimmer one is, the less chance one has of developing stones, but today the Pretty Professional Primigravida on the Pill has as bad a chance of getting gallstones as the Fat Fertile Fortyish Female.
Although claims have been made that taking aspirin regularly can decrease stone formation, these claims need further substantiation.
So, although ideally prevention would be the best medicine, we are still nowhere near that ideal.
Basically the aim of treatment still remains to rid the patient of his stones, but a range of techniques is now available to do this.
The first attempts to dissolve gallstones were made about a hundred years ago, when ether was directly infused into the gallbladder.
Today, we have agents like the Bile Acids, as well as drugs such as Lovastatin and Simvastatin which inhibit cholesterol formation in the body.
Overall, about 20% of patients with non-opaque gallstones are suitable for this kind of dissolution therapy - the ideal candidate being one who has less than 3 stones, each being smaller than 20 mm.
in diameter, in a normally functioning gallbladder.
Unfortunately, because the bile in these patients returns to its highly concentrated form within a few weeks of stopping dissolution therapy, about half of these patients gradually re-form stones.
Moreover, the process of dissolving gallstones by drugs takes a long time, at least a year.