Dr. Afroze Ahmad
Sue, a 34-year-old mother of two, had come to see me for recurrent right-side chest pains.
During the episodes, she would sweat profusely. Her chest pains would be associated with nausea, provoked by a fatty meal and would make her anxious and restless. She had been to the emergency room twice in the last six weeks. Her tests for heart attack were negative, and she was reassured and discharged on anxiety medications.
In my office, she lay on the exam table and appeared a little overweight, anxious and with a high blood pressure. As I attempted to examine her by placing my hand on her right lower chest, she almost shrieked with pain. This was a no-brainer for me to diagnose. She certainly was experiencing an attack. Fortunately, though, it was not a heart attack. She was having a gallstone attack.
I explained to Sue her diagnosis of gallstone attack and recommended, from my office, she report directly to the emergency room. With her consent, I personally called the surgeon who met with her at her bedside in the emergency room in less than an hour. She was admitted overnight and underwent gall bladder removal the next morning.
Upon her return office visit two weeks later, she remarked, “Dr. Ahmad, I am so glad it was not my heart.” I looked at Sue and replied, “Not so quick, as gallstones and heart disease can coexist.”
One in every four people with gallbladder stones also will have heart disease. The likelihood of heart disease in such a setting is there regardless of the presence or absence of risk factors for heart disease in that individual. Risk factors, such as obesity, diabetes and high blood pressure contribute to heart disease in people suffering from gallstones. However, people with gallstones who are otherwise in good shape and healthy also have been found to have underlying heart disease.
The explanation is that certain kinds of gallstones increase the cholesterol secretion, which leads to increased cholesterol production and subsequent development of heart disease. So, it goes without saying that adopting a lifestyle that would help prevent gallstones also may help in reducing the risk of heart disease.
Although there is no clear-cut or definite way to prevent gallstones, certain lifestyle changes go a long way in lowering the risk of gallstone formation. Try to stay at a healthy and relatively constant weight. Avoid crash diets with severe caloric reduction of less than 750 per day. In women, weight loss should be gradual and slow. So, a rebound weight gain is avoided, which may become a precursor for production of gallstones.
Do eat some healthy fats, as they aid in the contraction and emptying of the gallbladder and decrease the cholesterol secretion. Also, use of estrogens, whether to treat post-menopausal symptoms or as a birth control pill, may increase the risk of gallstones. Therefore, I encourage talking to your doctor regarding the risks and the merits of estrogen therapy.
The above article is based on actual conversations between Dr. Ahmad and her patients. The name and age has been changed to keep the patient’s identity confidential.
Dr. Afroze Ahmad is a cardiologist who cares and listens. She is a multiple board certified cardiologist practicing at Las Sendas Cardiology, located at 3514 N. Power Road, Suite 107.
For information, or to make an appointment, please call (480) 361-9949.