Friday, April 10, 2015

The Top Five Causes of Gallstones

As many as 20 million Americans have gallstones, according to the National Institutes of Health, but often, there are no symptoms. In fact, many people never experience discomfort and don’t even know they have gallstones, which may be as small as a grain of sand or as big as a golf ball.  Gallstones occur when there's an imbalance in the bile transportation process. Cholesterol stones can form when bile contains too much cholesterol, too much bilirubin or not enough bile salts.  When gallstones leave the gallbladder, they can become lodged in the bile duct resulting in a sharp debilitating pain.  Passing a gallstone can be an excruciating experience and the tiniest stone can create a very great pain. Obviously, a situation that everyone would wish to avoid. 

The large, yellow stones are composed of cholesterol, and the green and brown stones are indicative of bile pigments, such as biliverdin and stercobilin.

If you develop gallstones, you need not go on suffering, contact us for a consultation and we can determine your personal factors and the best individual treatment.

The Top Five Causes of Gallstones

Stress raises levels of the hormone cortisol, this depletes bile. Abdominal bloating subsides while we sleep and de-stress.

Switching to a vegan diet: Saturated fat is one of the key triggers of bile production. 
High estrogen levels: Birth control pills, hormone replacement therapy,  or pregnancy produces a rise in estrogen and can contribute to bile deficiency.
Low stomach acid:  Stomach acid activates bile production, low levels (i.e. from taking antacids) inhibit it.
Eating a lot of processed food: Preservatives and other toxic food additives, combined with a lack of detoxifying fresh vegetables, burden the liver and impair its ability to produce bile.
Gallstones occur when there's an imbalance in the bile transportation process. Gallstones can also occur when the gallbladder does not empty into the common bile duct completely or often enough, accumulating too much cholesterol, too much bilirubin or not enough bile salts in the gallbladder, forming what we call stones.

The following steps assist bile production, relieve gallstone symptoms, and may also help to gradually dissolve some gallstones.

Eat some saturated fat, because it signals the liver to produce bile- eggs, grass-fed meat, fatty fish, and coconut oil are good sources.
Eat 7 cups of vegetables daily, half in the form of greens and brightly colored veggies for the rest.

Avoid these foods because they are thought to aggravate gallbladder conditions:
§                       Nuts, nut butters, and peanuts
§                       Large, heavy, fatty meals
§                       Calcium carbonate, because it reduces stomach acid

If Your Gallbladder Has Been Removed … 

Follow the same steps above for those with gallbladders, but omit stone root and use bile salt this way:  Take the supplement before breakfast and then again before lunch and dinner if you have bloating or other symptoms. Once symptoms resolve, you can cut back by taking bile salt only before breakfast.

If You Are Overweight...

Your doctor will likely tell you to lose weight, because studies show that overweight people are more likely to have gallstones, but it isn't the excess weight which causes the stones. but a lack of bile production contributes to weight gain, because it interferes with healthy digestion and nutrient absorption, and makes you crave fried or sugary foods.
If you have gallstones, weight loss can aggravate the condition, because excess fat comes out through the liver and bile ducts. Therefore, taking bile salts is especially important during weight loss and can help prevent gallstone problems.

 

Eat These Vegetables

Greens improve the liver’s ability to make bile by enhancing detoxification—and a liver that is less burdened with toxins works more efficiently. Greens also help to make bile thinner, which allows bile to flow more easily and also lowers the risk of gallstones. The following veggies are particularly good at enhancing your own bile production:

  •                        Radishes
  •                        Broccoli
  •                        Cabbage
  •                        Brussels sprouts
  •                        Raw in salads or cooked: beets, beet tops, and kale 

Supplemental Options

1. Before or at the start of each meal: take a supplement of bile salts, which are made from purified ox bile. If you are a vegetarian, taking concentrated beet powder can enhance your bile production.

2. If bile salts don’t resolve your symptoms, you are most likely deficient in stomach acid, which tells the liver to produce bile. Restore stomach acid by taking betaine hydrochloride.

3. Take supplements of stone root, an herb that helps to dissolve stones and is available in pills, tinctures, and tea form.


[INSERT ADDITIONAL SUPPLEMENTAL OFFERINGS OR LINK TO SPECIFIC PRODUCTS HERE]





Source info:

Source: http://amazingwellnessmag.com/gallstones-the-real-cause-and-cure/




Cholesterol stones can form when bile contains too much cholesterol, too much bilirubin or not enough bile salts, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD). 
"Cholesterol is a naturally occurring substance within our bile," said Dr. Kalman Bencsath, a general surgeon at Cleveland Clinic in Ohio. "When you have an abnormal accumulation, you can wind up with cholesterol crystals precipitating out, and growing over time into what we call stones."
Gallstones can also occur when the gallbladder does not empty into the common bile duct completely or often enough. Women are twice as likely as men to develop gallstones because excess estrogen from pregnancy, hormone replacement therapy, and birth control pills may increase cholesterol levels and decrease gallbladder movement, which can facilitate gallstones.
Source:http://www.livescience.com/34726-gallstones-symptoms-treatment.html

What are gallstones?

When the chemicals in the gallbladder, cholesterol, calcium bilirubinate, and calcium carbonate are out of balance gallstones may form. There are two main types of gallstones:
  • Cholesterol gallstones - these may form if there is too much cholesterol in the bile? They are the main type of gallstones in the UK and the USA.

  • Pigment gallstones - these form when the bile has too much bilirubin. They are more common among patients who have liver disease, infected bile tubes or blood disorders, such as sickle-cell anemia.

What are the symptoms of gallstones?

The majority of people with gallstones have no symptoms at all. This is because the stones generally stay in the gallbladder and cause no problems. Sometimes, however, gallstones may lead to cholecystitis (inflamed gallbladder). Symptoms of gallbladder inflammation include:
  • Pain on the right-hand side of the body, just below the ribs
  • Back pain
  • Pain in the right shoulder
  • Nausea
  • Vomiting
  • Sweating
  • Restlessness.



  • Biliary colic - Sometimes the gallstones may pass down through the bile duct into the duodenum. When this happens the patient may experience biliary colic - a painful condition. The pain is felt in the upper part of the abdomen, but can also exist in the center of the abdomen, or a little to the right of it. Pain is more common about an hour after eating, especially if the patient has had a high-fat meal. The pain will be constant and will last a few hours, and then subside. Some patients will have non-stop pain for 24 hours, while others may experiences waves of pain.





  • Infection - If the gallstones have caused a gallbladder infection the patient may have a fever and experience shivering. In the majority of gallstone infection cases the patient will be hospitalized and have the gallstone surgically removed.





  • Jaundice - If the gallstone leaves the gallbladder and gets stuck in the bile duct it may block the passage of bile into the intestine. The bile will then seep into the bloodstream and the patient will show signs of jaundice - the skin and the whites of the eyes will be yellow. In most cases this complication will require the surgical removal of the gallstone. Some patients are lucky and the gallstone eventually passes into the intestine.





  • Pancreatitis - If a small gallstone passes through the bile duct and blocks the pancreatic duct, or causes a reflux of liquids and bile into the duct, the patient may develop pancreatitis.

  • What causes gallstones?

    Experts are not completely sure why some people develop a chemical imbalance in their gallbladder which causes gallstones, while others do not. However, we do know that gallstones are more common among:
    Source: http://www.medicalnewstoday.com/articles/153981.php


    GALLSTONES: THE REAL CAUSE AND CURE

    166587196Is surgery always necessary? Maybe not—and there are risks. Read on to learn what you can do to prevent gallstones, and about treatment alternatives

    As many as 20 million Americans have gallstones,according to the National Institutes of Health, but often, there are no symptoms. In fact, many people never experience discomfort and don’t even know they have gallstones, which may be as small as a grain of sand or as big as a golf ball. But sometimes, the stones can trigger severe pain and other symptoms. In conventional medicine, gallbladder removal is the treatment of choice for patients with any symptoms of gallstones. There is no question that surgery is necessary in many cases. When a patient’s gallbladder is infected or severely inflamed, gallbladder surgery is required as a matter of life and death. But in some other cases, gallbladder removal may not solve the problem and may even be a mistake.
    Studies show that gallstone symptoms, which can include abdominal pain, nausea, indigestion, bloating, and gas, don’t always disappear after surgery, although pain usually decreases significantly. One study, published in The British Journal of Surgery, found that 34 percent of patients still had some abdominal pain one year after their gallbladders were removed. And in other research, done by the British National Health Service, scientists found that some people without gallbladders still experienced diarrhea and bloating after eating fatty foods.

    How Your Gallbladder Works

    Medically considered non-essential, meaning we can live without it, the gallbladder is a holding tank for bile. The gallbladder itself does not make bile, a fluid made by the liver to break down fats in your digestive system.
    When you eat fat, the gallbladder contracts and releases bile through ducts that lead to the small intestine. There, bile breaks down fat so that you can absorb nutrients, such as the fat-soluble vitamins A, D, E, and K. If the gallbladder is missing, the liver continues to make bile; however, without a reservoir of bile, the liver may not be able to keep up with demand, and fat digestion may become impaired.
    • With or without a gallbladder, symptoms of insufficient bile include:
    • Cravings for fried or fatty foods
    • Not feeling satisfied after eating
    • Craving sugar after a meal
    • Itchy skin and eyes
    • Dry eyes
    • Hives
    • Sneezing
    • Bloating
    • Indigestion
    • Burping
    • Belching
    • Headaches, especially pain in the right temple or on the right side of the head
    • Pain or tension in the right fingers, hand, neck or shoulder, or under the ribs on the right side

    What Causes Gallstones? 

    “Gallstones really develop from a deficiency of bile,” says Alexandria, Virginia-based Eric Berg, DC (drberg.com), author of The 7 Principles of Fat Burning. In addition to breaking down fat in food, bile also breaks down cholesterol and other substances that can accumulate into stones. Most often, says Berg, a bile deficiency is caused by one or more of the following:
    Stress: It raises levels of the hormone cortisol, which depletes bile. This is why abdominal bloating is typically worse late in the day and subsides overnight, while we sleep and de-stress.
    Switching to a vegan diet: Rare in a plant-based diet, saturated fat is one of the key triggers of bile production. In cultures that have been predominantly vegan for many generations, however, the body has adapted.
    High estrogen levels: Birth control pills, hormone replacement therapy, pregnancy, or high intake of unfermented soy foods can cause estrogen to rise and thereby contribute to bile deficiency.
    Low stomach acid: Because stomach acid activates bile production, low levels (due to taking antacids, for example) inhibit it.
    Eating a lot of processed food: Preservatives and other toxic food additives, combined with a lack of detoxifying fresh vegetables, burden the liver and impair its ability to produce bile.

    If you Have Gallstones … 

    Berg’s clinical experience with thousands of patients shows that these steps help enhance bile production, relieve gallstone symptoms, and may also help to gradually dissolve gallstones, especially small ones.
    1. Before or at the start of each meal: take a supplement of bile salts, which are made from purified ox bile. If you’re vegetarian or vegan, there are no plant sources of bile salts, but taking concentrated beet powder can enhance your internal bile production.
    2. Take supplements of stone root, an herb that helps to dissolve stones and is available in pills, tinctures, and tea form.
    3. Eat some saturated fat, because it signals the liver to produce bile. Eggs, grass-fed meat, fatty fish, and coconut oil are good sources.
    4. Eat 7 cups of vegetables daily, half in the form of greens and brightly colored veggies for the rest.
    5. Avoid these foods because they are thought to aggravate gallbladder conditions:
    • Nuts, nut butters, and peanuts
    • Large, heavy, fatty meals
    • Calcium carbonate, because it reduces stomach acid
    6. If bile salts don’t resolve your symptoms, you are most likely deficient in stomach acid, says Berg, who explains that stomach acid tells the liver to produce bile—with or without a gallbladder. Restore stomach acid by taking betaine hydrochloride (abbreviated betaine HCI or HCL).
    If Your Gallbladder Has Been Removed … 
    Follow the same steps above for those with gallbladders, but omit stone root and use bile salt this way:Take the supplement before breakfast and then again before lunch and dinner if you have bloating or other symptoms. Once symptoms resolve, you can cut back by taking bile salt only before breakfast.

    A Common Myth

    “If you’re overweight and have gallstones, your doctor will typically tell you to lose weight,” says Berg, but this is faulty reasoning. Studies show that overweight people are more likely to have gallstones, but that doesn’t mean the excess weight causes the stones. More likely, says Berg, a lack of bile production contributes to weight gain, because it interferes with healthy digestion and nutrient absorption, and makes you crave fried or sugary foods.
    If you have gallstones, weight loss can aggravate the condition, because excess fat comes out through the liver and bile ducts. Therefore, taking bile salts is especially important during weight loss and can help prevent gallstone problems.

    BEST VEGGIE CHOICES

    Whether you have a gallbladder or not, says Berg, greens improve the liver’s ability to make bile by enhancing detoxification—and a liver that is less burdened with toxins works more efficiently. Greens also help to make bile thinner, which allows bile to flow more easily and also lowers the risk of gallstones. (Although rare, stones can still form in the liver and lodge in ducts even when the gallbladder has been removed.) The following veggies are particularly good at enhancing your own bile production:
    •  Radishes
    • Cruciferous vegetables such as broccoli, cabbage, and Brussels sprouts
    • Raw in salads or cooked: beets, beet tops, and kale (see recipe for Kale Shake below)
    94298191

    Source: http://amazingwellnessmag.com/gallstones-the-real-cause-and-cure/

    The Common Risk Factors for Gallstone Formation

    Did you know that some people are more likely to have gallstones than others?  There are proven factors that increase your odds of suffering from the debilitating pain that comes with this condition.  These factors do not guarantee you will get gallstones, but they do increase your chances if...

    Your bile contains too much cholesterol.  Normally, your bile contains enough chemicals to dissolve the cholesterol excreted by your liver.  But if your liver excretes more cholesterol than your bile can dissolve, the excess cholesterol may form into crystals and eventually into stones.

    Your bile contains too much bilirubin.  Bilirubin is a chemical that's produced when your body breaks down red blood cells.  Certain conditions cause your liver to make too much bilirubin, including liver cirrhosis, biliary tract infections and certain blood disorders.  The excess bilirubin contributes to gallstone formation.

    Your gallbladder doesn't empty correctly. If your gallbladder doesn't empty completely or often enough, bile may become very concentrated and this contributes to the formation of gallstones.

    These risk factors that include:
    • Being female
    • Being age 60 or older
    • Being an American Indian
    • Being a Mexican-American
    • Being overweight or obese
    • Being pregnant
    • Eating a high-fat diet
    • Eating a high-cholesterol diet
    • Eating a low-fiber diet
    • Having a family history of gallstones
    • Having diabetes
    • Losing weight very quickly
    • Taking some cholesterol-lowering medications
    • Taking medications that contain estrogen, such as hormone therapy drugs
    Gallstone disease is one of the most common and costly of all digestive diseases. The third National Health and Nutrition Examination Survey estimated that 6.3 million men and 14.2 million women aged 20 to 74 in the United States have gallbladder disease.
    Over the past two decades, a great deal has been learned about the risk factors for gallstones.  Ultrasonography has played a major role in this process, providing a rapid, risk-free method of screening large populations. 
    We specialize in lifestyle-oriented solutions and can recommend supplements providing a surgery-free alternative to manage your individual risk factors.  Our goal is to see you healthy and whole.  A personal consultation can get you on your way to understanding and proactively controlling your digestive health.


    RISK FACTORS IN WOMEN

    Women are much more likely than men to develop gallstones. Gallstones occur in nearly 25% of women in the U.S. by age 60, and as many as 50% by age 75. In most cases, they have no symptoms. In general, women are probably at increased risk because estrogen stimulates the liver to remove more cholesterol from blood and divert it into the bile.
    Pregnancy. Pregnancy increases the risk for gallstones, and pregnant women with stones are more likely to have symptoms than nonpregnant women. Surgery should be delayed until after delivery if possible. In fact, gallstones may disappear after delivery. If surgery is necessary, laparoscopy is the safest approach.
    Hormone Replacement Therapy. Several large studies have shown that the use of hormone replacement therapy (HRT) doubles or triples the risk for gallstones, hospitalization for gallbladder disease, or gallbladder surgery. Estrogen raises triglycerides, a fatty acid that increases the risk for cholesterol stones. How the hormones are delivered may make a difference, however. Women who use a patch or gel form of HRT face less risk than those who take a pill. HRT may also be a less-than-attractive option for women because studies have shown it has negative effects on the heart and increases the risk for breast cancer.

    RISK FACTORS IN MEN

    About 20% of men have gallstones by the time they reach age 75. Because most cases do not have symptoms, however, the rates may be underestimated in elderly men. One study of nursing home residents reported that 66% of the women and 51% of the men had gallstones. Men who have their gallbladder removed are more likely to have severe disease and surgical complications than women.

    RISKS IN CHILDREN

    Gallstone disease is relatively rare in children. When gallstones do occur in this age group, they are more likely to be pigment stones. Girls do not seem to be more at risk than boys. The following conditions may put children at higher risk:
    • Spinal injury
    • History of abdominal surgery
    • Sickle-cell anemia
    • Impaired immune system
    • Receiving nutrition through a vein (intravenous)

    ETHNICITY

    Because gallstones are related to diet, particularly fat intake, the incidence of gallstones varies widely among nations and regions. For example, Hispanics and Northern Europeans have a higher risk for gallstones than do people of Asian and African descent. People of Asian descent who develop gallstones are most likely to have the brown pigment type.
    Native North and South Americans, such as Pima Indians in the U.S. and native populations in Chile and Peru, are especially prone to developing gallstones. Pima women have an 80% chance of developing gallstones during their lives, and virtually all native Indian females in Chile and Peru develop gallstones. Such cases are most likely due to a combination of genetic and dietary factors.

    GENETICS

    Having a family member or close relative with gallstones may increase the risk. Up to one-third of cases of painful gallstones may be related to genetic factors.
    A mutation in the gene ABCG8 significantly increases a person's risk of gallstones. This gene controls a cholesterol pump that transports cholesterol from the liver to the bile duct. It appears this mutation may cause the pump to continuously work at a high rate.
    Defects in transport proteins involved in biliary lipid secretion appear to predispose certain people to gallstone disease, but this alone many not be sufficient to create gallstones. Studies indicate that the disease is complex and may result from the interaction between genetics and environment. Some studies suggest immune and inflammatory mediators may play key roles.

    DIABETES

    People with diabetes are at higher risk for gallstones and have a higher-than-average risk for acalculous gallbladder disease (without stones). Gallbladder disease may progress more rapidly in patients with diabetes, who tend to have worse infections.

    OBESITY AND WEIGHT CHANGES

    Obesity. Being overweight is a significant risk factor for gallstones. In such cases, the liver over-produces cholesterol, which is delivered into the bile and causes it to become supersaturated.
    Weight Cycling. Rapid weight loss or cycling (dieting and then putting weight back on) further increases cholesterol production in the liver, which results in supersaturation and an increased risk for gallstones.
    • The risk for gallstones is as high as 12% after 8 -16 weeks of restricted-calorie diets.
    • The risk is more than 30% within 12 - 18 months after gastric bypass surgery.
    About one-third of gallstone cases in these situations have symptoms. The risk for gallstones is highest in the following dieters:
    • Those who lose more than 24% of their body weight
    • Those who lose more than 1.5 kg (3.3 lb.) a week
    • Those on very low-fat, low-calorie diets
    Men are also at increased risk for developing gallstones when their weight fluctuates. The risk increases proportionately with dramatic weight changes as well as with frequent weight cycling.
    Bariatric Surgery. Patients who have either Roux-en-Y or laparoscopic banding bariatric surgery are at increased risk for gallstones. For this reason, many centers request that patients undergo cholecystectomy before their bariatric procedure. However, doctors are now questioning this practice.

    METABOLIC SYNDROME

    Metabolic syndrome is a cluster of conditions that includes obesity (especially belly fat), low HDL (good) cholesterol, high triglycerides, high blood pressure, and high blood sugar. Research suggests that metabolic syndrome is a risk factor for gallstones.

    LOW HDL CHOLESTEROL, HIGH TRIGLYCERIDES AND THEIR TREATMENT

    Although gallstones are formed from the supersaturation of cholesterol in the bile, high total cholesterol levels themselves are not necessarily associated with gallstones. Gallstone formation is associated with low levels of "good" HDL cholesterol and high triglyceride levels. Some evidence suggests that high levels of triglycerides may impair the emptying actions of the gallbladder.
    Unfortunately, some fibrates (drugs used to correct these conditions) actually increase the risk for gallstones by increasing the amount of cholesterol secreted into the bile. These medications include gemfibrozil (Lopid) and fenofibrate (Tricor). Other cholesterol-lowering drugs do not have this effect.

    OTHER RISK FACTORS

    Prolonged Intravenous Feeding. Prolonged intravenous feeding reduces the flow of bile and increases the risk for gallstones. Up to 40% of patients on home intravenous nutrition develop gallstones, and the risk may be higher in patients on total intravenous nutrition. It is suspected that the cause is lack of stimulation in the gut, because patients who also take some food by mouth have less risk of developing gallstones. However, treatment for gallstones in this population is associated with a low risk of complications.
    Crohn's Disease. Crohn's disease, an inflammatory bowel disorder, leads to poor reabsorption of bile salts from the digestive tract and substantially increases the risk of gallbladder disease. Patients over age 60 and those who have had numerous bowel operations (particularly in the region where the small and large bowel meet) are at especially high risk.
    Cirrhosis. Cirrhosis poses a major risk for gallstones, particularly pigment gallstones.
    Organ Transplantation. Bone marrow or solid organ transplantation increases the risk of gallstones. The complications can be so severe that some organ transplant centers require the patient's gallbladder be removed before the transplant is performed.
    Medications. Octreotide (Sandostatin) poses a risk for gallstones. In addition, cholesterol-lowering drugs known as fibrates and thiazide diuretics may slightly increase the risk for gallstones.
    Blood Disorders. Chronic hemolytic anemia, including sickle cell anemia, increases the risk for pigment gallstones.
    Heme Iron. High consumption of heme iron, the type of iron found in meat and seafood, has been shown to lead to gallstone formation in men. Gallstones are not associated with diets high in non-heme iron foods such as beans, lentils, and enriched grains.

    Source:  http://www.mayoclinic.org/diseases-conditions/gallstones/basics/risk-factors/con-20020461
    Source: http://www.uptodate.com/contents/epidemiology-of-and-risk-factors-for-gallstones
    Source:  http://www.nytimes.com/health/guides/disease/gallstones/risk-factors.html






    It's not clear what causes gallstones to form. Doctors think gallstones may result when:
    • Your bile contains too much cholesterol.Normally, your bile contains enough chemicals to dissolve the cholesterol excreted by your liver. But if your liver excretes more cholesterol than your bile can dissolve, the excess cholesterol may form into crystals and eventually into stones.
    • Your bile contains too much bilirubin. Bilirubin is a chemical that's produced when your body breaks down red blood cells. Certain conditions cause your liver to make too much bilirubin, including liver cirrhosis, biliary tract infections and certain blood disorders. The excess bilirubin contributes to gallstone formation.
    • Your gallbladder doesn't empty correctly. If your gallbladder doesn't empty completely or often enough, bile may become very concentrated and this contributes to the formation of gallstones.

    Types of gallstones

    Types of gallstones that can form in the gallbladder include:
    • Cholesterol gallstones. The most common type of gallstone, called a cholesterol gallstone, often appears yellow in color. These gallstones are composed mainly of undissolved cholesterol, but may contain other components.
    • Pigment gallstones. These dark brown or black stones form when your bile contains too much bilirubin.


    Gallstone disease is one of the most common and costly of all digestive diseases. The third National Health and Nutrition Examination Survey estimated that 6.3 million men and 14.2 million women aged 20 to 74 in the United States had gallbladder disease [1].
    Over the past two decades, a great deal has been learned about the epidemiology of and risk factors for gallstones.  Ultrasonography has played a major role in this process, providing a rapid, risk-free method of screening large populations. 
    EPIDEMIOLOGY
    Epidemiologic data are available from a number of large European and American populations (table 2). These studies have revealed a marked variation in overall gallstone prevalence between different ethnic populations. As a general rule, there appears to be higher rates of cholelithiasis in western Caucasian, Hispanic, and Native American populations and lower rates in eastern European, African American, and Japanese populations [2-18].
    In the United States, the age standardized prevalence of gallbladder disease was estimated based upon a sample of more than 14,000 persons aged 20 to 74 in whom gallbladder disease was detected by the presence of gallstones or cholecystectomy on ultrasonography [1].
    Source: http://www.uptodate.com/contents/epidemiology-of-and-risk-factors-for-gallstones

    Risk Factors

    More than 25 million Americans have gallstones, and a million are diagnosed each year. However, only 1 - 3% of the population complains of symptoms during the course of a year, and fewer than half of these people have symptoms that return.

    RISK FACTORS IN WOMEN

    Women are much more likely than men to develop gallstones. Gallstones occur in nearly 25% of women in the U.S. by age 60, and as many as 50% by age 75. In most cases, they have no symptoms. In general, women are probably at increased risk because estrogen stimulates the liver to remove more cholesterol from blood and divert it into the bile.
    Pregnancy. Pregnancy increases the risk for gallstones, and pregnant women with stones are more likely to have symptoms than nonpregnant women. Surgery should be delayed until after delivery if possible. In fact, gallstones may disappear after delivery. If surgery is necessary, laparoscopy is the safest approach.
    Hormone Replacement Therapy. Several large studies have shown that the use of hormone replacement therapy (HRT) doubles or triples the risk for gallstones, hospitalization for gallbladder disease, or gallbladder surgery. Estrogen raises triglycerides, a fatty acid that increases the risk for cholesterol stones. How the hormones are delivered may make a difference, however. Women who use a patch or gel form of HRT face less risk than those who take a pill. HRT may also be a less-than-attractive option for women because studies have shown it has negative effects on the heart and increases the risk for breast cancer.

    RISK FACTORS IN MEN

    About 20% of men have gallstones by the time they reach age 75. Because most cases do not have symptoms, however, the rates may be underestimated in elderly men. One study of nursing home residents reported that 66% of the women and 51% of the men had gallstones. Men who have their gallbladder removed are more likely to have severe disease and surgical complications than women.

    RISKS IN CHILDREN

    Gallstone disease is relatively rare in children. When gallstones do occur in this age group, they are more likely to be pigment stones. Girls do not seem to be more at risk than boys. The following conditions may put children at higher risk:
    • Spinal injury
    • History of abdominal surgery
    • Sickle-cell anemia
    • Impaired immune system
    • Receiving nutrition through a vein (intravenous)

    ETHNICITY

    Because gallstones are related to diet, particularly fat intake, the incidence of gallstones varies widely among nations and regions. For example, Hispanics and Northern Europeans have a higher risk for gallstones than do people of Asian and African descent. People of Asian descent who develop gallstones are most likely to have the brown pigment type.
    Native North and South Americans, such as Pima Indians in the U.S. and native populations in Chile and Peru, are especially prone to developing gallstones. Pima women have an 80% chance of developing gallstones during their lives, and virtually all native Indian females in Chile and Peru develop gallstones. Such cases are most likely due to a combination of genetic and dietary factors.

    GENETICS

    Having a family member or close relative with gallstones may increase the risk. Up to one-third of cases of painful gallstones may be related to genetic factors.
    A mutation in the gene ABCG8 significantly increases a person's risk of gallstones. This gene controls a cholesterol pump that transports cholesterol from the liver to the bile duct. It appears this mutation may cause the pump to continuously work at a high rate.
    Defects in transport proteins involved in biliary lipid secretion appear to predispose certain people to gallstone disease, but this alone many not be sufficient to create gallstones. Studies indicate that the disease is complex and may result from the interaction between genetics and environment. Some studies suggest immune and inflammatory mediators may play key roles.

    DIABETES

    People with diabetes are at higher risk for gallstones and have a higher-than-average risk for acalculous gallbladder disease (without stones). Gallbladder disease may progress more rapidly in patients with diabetes, who tend to have worse infections.

    OBESITY AND WEIGHT CHANGES

    Obesity. Being overweight is a significant risk factor for gallstones. In such cases, the liver over-produces cholesterol, which is delivered into the bile and causes it to become supersaturated.
    Weight Cycling. Rapid weight loss or cycling (dieting and then putting weight back on) further increases cholesterol production in the liver, which results in supersaturation and an increased risk for gallstones.
    • The risk for gallstones is as high as 12% after 8 -16 weeks of restricted-calorie diets.
    • The risk is more than 30% within 12 - 18 months after gastric bypass surgery.
    About one-third of gallstone cases in these situations have symptoms. The risk for gallstones is highest in the following dieters:
    • Those who lose more than 24% of their body weight
    • Those who lose more than 1.5 kg (3.3 lb.) a week
    • Those on very low-fat, low-calorie diets
    Men are also at increased risk for developing gallstones when their weight fluctuates. The risk increases proportionately with dramatic weight changes as well as with frequent weight cycling.
    Bariatric Surgery. Patients who have either Roux-en-Y or laparoscopic banding bariatric surgery are at increased risk for gallstones. For this reason, many centers request that patients undergo cholecystectomy before their bariatric procedure. However, doctors are now questioning this practice.

    METABOLIC SYNDROME

    Metabolic syndrome is a cluster of conditions that includes obesity (especially belly fat), low HDL (good) cholesterol, high triglycerides, high blood pressure, and high blood sugar. Research suggests that metabolic syndrome is a risk factor for gallstones.

    LOW HDL CHOLESTEROL, HIGH TRIGLYCERIDES AND THEIR TREATMENT

    Although gallstones are formed from the supersaturation of cholesterol in the bile, high total cholesterol levels themselves are not necessarily associated with gallstones. Gallstone formation is associated with low levels of "good" HDL cholesterol and high triglyceride levels. Some evidence suggests that high levels of triglycerides may impair the emptying actions of the gallbladder.
    Unfortunately, some fibrates (drugs used to correct these conditions) actually increase the risk for gallstones by increasing the amount of cholesterol secreted into the bile. These medications include gemfibrozil (Lopid) and fenofibrate (Tricor). Other cholesterol-lowering drugs do not have this effect.

    OTHER RISK FACTORS

    Prolonged Intravenous Feeding. Prolonged intravenous feeding reduces the flow of bile and increases the risk for gallstones. Up to 40% of patients on home intravenous nutrition develop gallstones, and the risk may be higher in patients on total intravenous nutrition. It is suspected that the cause is lack of stimulation in the gut, because patients who also take some food by mouth have less risk of developing gallstones. However, treatment for gallstones in this population is associated with a low risk of complications.
    Crohn's Disease. Crohn's disease, an inflammatory bowel disorder, leads to poor reabsorption of bile salts from the digestive tract and substantially increases the risk of gallbladder disease. Patients over age 60 and those who have had numerous bowel operations (particularly in the region where the small and large bowel meet) are at especially high risk.
    Cirrhosis. Cirrhosis poses a major risk for gallstones, particularly pigment gallstones.
    Organ Transplantation. Bone marrow or solid organ transplantation increases the risk of gallstones. The complications can be so severe that some organ transplant centers require the patient's gallbladder be removed before the transplant is performed.
    Medications. Octreotide (Sandostatin) poses a risk for gallstones. In addition, cholesterol-lowering drugs known as fibrates and thiazide diuretics may slightly increase the risk for gallstones.
    Blood Disorders. Chronic hemolytic anemia, including sickle cell anemia, increases the risk for pigment gallstones.
    Heme Iron. High consumption of heme iron, the type of iron found in meat and seafood, has been shown to lead to gallstone formation in men. Gallstones are not associated with diets high in non-heme iron foods such as beans, lentils, and enriched grains.

    Source:  http://www.nytimes.com/health/guides/disease/gallstones/risk-factors.html

    Source: PDF
    http://www.hopkinsmedicine.org/gastroenterology_hepatology/_pdfs/pancreas_biliary_tract/gallstone_disease.pdf

    A gallstone, also called a cholelith (/ˈkoʊləlɪθ/), is a calculus (stone) formed within the gallbladder as a concretion of bile components. Lithiasis (stone formation) in the gallbladder is called cholelithiasis (/ˌkoʊləlɪˈθaɪəsɨs/). Gallstones are formed in the gallbladder but may pass distally into other parts of the biliary tract such as the cystic duct, common bile duct, pancreatic duct or the ampulla of Vater. Rarely, in cases of severe inflammation, gallstones may erode through the gallbladder into adherent bowel potentially causing an obstruction termed gallstone ileus.[1]
    Presence of gallstones in the gallbladder may lead to acute cholecystitis,[2] aninflammatory condition characterized by retention of bile in the gallbladder and often secondary infection by intestinal microorganisms, predominantlyEscherichia coli, Klebsiella, Enterobacter, and Bacteroides species.[3]Presence of gallstones in other parts of the biliary tract can cause obstruction of the bile ducts, which can lead to serious conditions such as ascending cholangitis or pancreatitis. Either of these two conditions can be life-threatening and are therefore considered to be medical emergencies.
    Gallstones can vary in size and shape from as small as a grain of sand to as large as a golf ball.[4] The gallbladder may contain a single large stone or many smaller ones. Pseudoliths, sometimes referred to as sludge, are thick secretions that may be present within the gallbladder, either alone or in conjunction with fully formed gallstones. 

    Source: http://en.wikipedia.org/wiki/Gallstone

    Source:  http://www.mayoclinic.org/diseases-conditions/gallstones/basics/causes/con-20020461

    Thursday, August 28, 2014

    We Are All Self-Employed

    WE ARE ALL SELF-EMPLOYED

    I think I got that thought from the book Making A Living Without A Job by Barbara Winter.  It is true that we choose where we will be employed on what terms and what we will or won't do for money, benefits, security, and meaningful work.  Yet there is a bit of a conundrum as most of us who want to work on our own terms also like to eat.  Which is why so many of our parents tried to redirect us if we said we wanted to be an artist, writer or musician.  Sometimes they discouraged us to aspire to greater things and settle for safer things.  Oh yes, youth does lend itself to dreaming, but age and experience to settling- to compromise or...resignation.

    It use to be in this country most people were self-employed.  Around the Industrial Revolution came the switch that more people were working for someone else.  The change was from making a life to making a living.  Instead of working on our own American Dream now we could work on someone else's dream and still get enough for ourselves to be comfortable.  It was safer this way- let someone else take the risk.

    Things have changed.  Employers and companies are looking to increase their profit margins, they don't regard employees as helping them to build their dream.  Employees are not as loyal to their companies either and they don't believe the boss is looking for a win/win, risk is everywhere.  Lower wages, less opportunity to move up the ladder, an emphasis on profits over pride in what is produced- all these things are contributing to more people using their skills to create a job rather than waiting for some HR department to look at their resume and call them back.

    My father in law worked at one company from age 19 to retirement at 65.  My Dad worked for a company for 26 years and they closed the doors one day in the late 70's.  He never recovered from that loss.  In contrast, I have worked in 3 very different fields (real estate, ministry and education) and held numerous other short term jobs in between.  They both thought it shameful that I had to collect unemployment.  Neither of them had a college education.  What was wrong with me?  Things have changed.

    What do you want from a job?  Do you want greater earning potential?  The ability to travel while you work?  Freedom to work from home?  Flexible hours?  Creative freedom?  A desire to do more meaningful work?  These all come at a price.  Comfort and risk ar in opposition in this equation.  There are opportunities but anyone who takes them needs to leave laziness and self-doubt at the door.

    How does one design a career around a dream?  I believe that I got this idea from Chris Guillebeau (Must read: his books The Art of Non-Conformity and The $100 Start Up)- he said that you should imagine the Perfect Day- waking up in the perfect place, working the perfect work on the perfect schedule, having the perfect life- even describing the house you are in, the clothes you have in your closet, who is around you and what you have for breakfast.  Write all this down- the whole day.  The purpose is to slowly begin to move in the direction of that Perfect Day.

    If you can't see it, you will be it.

    I will leave you with one thought, I got this off Pinterest:

    Making a life change is pretty scarey.
    Know what is even scarier?
    Regret.


    Thursday, July 17, 2014

    Picking Fruit

    PICKING FRUIT    


    Blueberries $1.86 a quart.  Pumpkins $2.50.  Apples $3.98 for a 5 lb. bag.  At these prices you might wonder, why anyone would want to pick their own fruit?  I grew up in Michigan, where apples, blueberries, cherries, peaches and other fruits are plentiful. Fruit farms are abundant there and picking your own fruit is a common practice.  Within 5 miles of our farm were a dozen orchards and fruit farms.

    In a day when fresh is defined as “a couple days old” or “refrigerated but not frozen”, many people have never experienced the joy of eating a fruit just off the vine, tree or bush.  There is an undeniable value in handpicking food for your family.  Maybe it doesn't take much skill to select fruit.  Having the freedom to choose the choicest berries off the bush and not just accept from the grocers produce department a plastic quart container half full of berries you would have not picked outweighs the convenience for me.  We have become a people who cannot recognize quality fruit, let alone whether that fruit is ripe.  How many times have you heard a person asking aloud, “How do you know if this is ripe?” in the produce section?


    The next time your kids (or grandkids) say they are bored, load them in the car and take them to the nearest fruit farm and give them an experience that will reconnect them with the natural processes of growth and the intentional miracle of a harvest. Your local grocer’s produce sections for their cheaper prices and convenience, cannot compare to farm freshness.  If you are fortunate, you might be able to show them how fruit is graded, juiced, processed and packaged for market.  Go ahead, make a memory today.

    Bearing fruit

    I had this moment last night when I realized what a failure I am as a Christian. Is it humility?  I am not so sure, it might be.  When there is nothing in your life that seems to be bearing fruit, when you are not engaged in using your gifts, not engaging with others, and have no resources to give other than time, talent and energy...a person can feel like he is just taking up space.

    I have heard whispers in my ear in the dark that I am just not as good as I think I am at music, at ministry, at teaching, at caring for others, at writing, at life.  Events have transpired that would seem to confirm some of that, and I am the worst person to ask regarding my abilities and true gifts.  I am so insecure and blind when it comes to perspective on myself.

    Part of this comes from not really feeling like I have anything to contribute at our current church.  Normally I have been in the worship band and youth ministry but my friend Scott Pagel has such freedom and skill on solo guitar and vocals - he has such a sweet spot in the song of God sung over us that I dare not attempt to add any more.  There are only a couple of teens so no youth ministry seems warranted.  I know I am good with kids, but who wants a fat balding guy for their youth leader anyway?  I think sometimes I should find a church, ANY church that needs a worship leader and help them out.

    And missions... I use to be so active in the mission field, in serving others and supporting helpful organizations, but I haven't done a trip since 2009.  Haven't worked in a soup kitchen in a couple of years, Habitat for Humanity folded in Lebanon, we have worked at Matthew 25 a few times- I guess I am feeling like my faith is not bearing fruit.  That it is all talk and no action lately.  There must be more than words.