General Question

hearkat's avatar

Is the gallbladder the new appendix?

Asked by hearkat (20949 points ) December 12th, 2012

In the past couple years, I have heard numerous people talk about having gallstones and gallbladder surgery; yet I haven’t heard of anyone having appendicitis or an appendectomy in several years (other than a fellow jelly, if I remember correctly).

Does anyone know of statistics on these procedures, or of any clinical theories as to why the gallbladder is becoming a nuisance these days? Is it something about how our diets have changed?

I’m putting this in General, but I’m opening the discussion to some degree of opinion, supposition, and debate on how the human body is evolving – for better or worse – in response to changes in our lifestyles as technology advances. Just please be respectful, and let’s not turn this into a science vs. religion debate.

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14 Answers

marinelife's avatar

It is the poor diet of Americans that causes all of the gallbladder problems.

Seek's avatar

The gallbladder stores bile and aids in the digestion of fats. Gallstones are formed by fats that aren’t broken down in the bile. There are “soft” stones formed by fats, and “hard” stones formed by protein.

80% of people with gallstones are considered “asymptomatic” – they never know they have them unless they’re found accidentally during an unrelated procedure.

Some of us are unlucky enough to have a genetic predisposition to symptomatic cholycystiasis. Every woman in my family has had gallbladder problems, going back to my great-grandmother. Unfortunately, mine was such that change in diet only held off the symptoms for a few months at a time. I went vegetarian, changed to a low-fat diet… didn’t work. Still ended up with gallstones. After three years, it got so bad the only option was to have the cholycystectomy. So I would alter @marinelife‘s comment to “some” or “many” of the gallbladder problems, certainly not “all”. Some may be aware that in Medieval times doctors blamed most disease on bile. Well, when you’ve got a diseased gallbladder, there’s plenty of yellow bile to go around, and no mistake.

I’ve heard that the gallbladder was important when we walked on all-fours, and that a separate storage compartment for bile isn’t totally necessary when we have gravity to keep the bile out of our livers.

Mariah's avatar

I don’t know a ton on the subject, but I want to throw it out there as someone who gets kidney stones, specifically the calcium-oxalate variety, of which some gallstones are also composed, that the fix for these stones is to eat a low oxalate diet. Some examples of foods that are high in oxalate: spinach, strawberries, beets, rhubarb, chick peas, etc. etc. Nearly all fruits and vegetables. So yeah, now I’m in the ironic situation that I have to avoid spinach for health reasons. It is completely untrue that a poor diet causes all these things. If I ate nothing but carbs and bacon then I wouldn’t get kidney stones/gallstones.

I don’t know the answer but I find @Seek_Kolinahr‘s answer in her last line interesting. Evolution isn’t so quick to follow when our lifestyles change, and sometimes our bodies are maladapted to our current environment for that reason.

tedd's avatar

Random gallbladder story:

My neighbor growing up, a very good friend of my moms, had like 4 or 5 gall bladders. She had them all removed my freshmen year of college. She’s in medical dictionaries as having the most on record.

filmfann's avatar

My sister has had both removed in the last 5 years or so.
Losing the gall bladder has caused her to change her diet, and she has lost a lot of weight.

Cupcake's avatar

The rates of cholecystectomy have increased since the introduction of laproscopic surgical treatment. It is interesting to note that severe gall bladder disease has not increased, but elective surgeries have.

Also, intestinal disease is a risk factor. Given that obesity rates are vastly rising and the strong research about inflammation, especially intestinal inflammation, I would be willing to guess that lifestyle factors (diet, weight, obesity, inflammation) have a role to play as well.

Anecdotally, my husband had emergent appendix removal relatively recently, and my teenager was on the cusp of having surgery… but ended up not needing it. I am personally not of the impression that appendicitis/surgery rates are declining… but I think they are more common in certain age groups.

Judi's avatar

I think that the higher rates have something to do with our nations higher consumption of fat. Of course there are people who have issues because of hereditary. I don’t know scientifically if it’s related but at least half the people I know who lost a bunch of weight on the Atkins diet when it was popular ended up having gall bladder surgery.

Rarebear's avatar

Cholecystitis has always been a problem. It’s not new.

hearkat's avatar

@Cupcake – I do suspect that the change in my social groups as I’ve aged is a factor in my hearing more about the gallbladder and less about the appendix these days. I hadn’t considered how changes in surgical techniques would increase the number of procedures, though.

@Judi and @Mariah – your comments about high-protein (Atkins-type) diets are somewhat contradictory, so I’m confused…

Seek's avatar

Methinks it may have something to do with a drastic change in diet – namely feeling free to eat lots and lots of high-fat, high-cholesterol meats, and not balancing it with lower-fat grains and vegetables.

My first gallbladder attack happened the first week I had tried Paleo-dieting – another high-protein diet. Today’s farmed meats have a much higher fat content than “free range” meats.

Judi's avatar

@hearkat , the people I knew who were on Atkins ate as much beef, bacon and high fat foods as they wanted, they just avoided carbs. It seemed like a very high fat diet to me.

geeky_mama's avatar

Personally my gallbladder had to be removed directly after my second pregnancy. It had nothing to do with my diet (which was very good, heavy on raw veggies & fruits if anything, not high fat) – but apparently had to do with hyperemesis gravidarum aka: HG (yes, the same thing that Princess Kate was recently hospitalized with).
Doctors don’t know why – but it frequently happens that biliary sludge occurs when (pregnant women) experience hyperemesis gravidarum and causes gallstones to form and often obstruct the biliary ducts (and they tend to be LARGE gallstones…again, don’t know why—this is just what my surgeon said). An abstract for the medically inclined to read is here.

..So, at least in my case..no clear evidence of evolution or high-fat diet at play, just evidence that I, like Charlotte Brontë, would definitely have died had I been pregnant in another era before IV hydration, PICC lines and Zofran existed. Yay for Modern Medicine!!

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