Abstract
The prevalence of gall stone disease in a stratified random sample of 1896 British adults (72.2% of those approached) was established using real time ultrasound. The prevalence rose with age, except in women of 40-49 years, so that at 60-69 years, 22.4% of women and 11.5% of men had gall stones or had undergone cholecystectomy. The cholecystectomy rate of people with gall stone disease was higher in women than in men (43.5% v 24%, p less than 0.05). Very few subjects with gall stones had convincing biliary symptoms. In women, 10.4% had symptoms according to a questionnaire definition of biliary pain and 6.3% according to conventional history taking, while no men at all admitted to biliary pain. Nevertheless, cholecystectomy in men had nearly always been preceded by convincing biliary symptoms. The age at cholecystectomy was, on average, nine years less than the age at detection of silent gall stones in both sexes. It is concluded that either gall stones are especially prone to cause symptoms in younger people or that there are two kinds of cholelithiasis - symptomatic and silent. The lack of symptomatic gall stones in cross sectional surveys is probably due to their rapid diagnosis and treatment.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bainton D., Davies G. T., Evans K. T., Gravelle I. H. Gallbladder disease. Prevalence in a South Wales industrial town. N Engl J Med. 1976 May 20;294(21):1147–1149. doi: 10.1056/NEJM197605202942103. [DOI] [PubMed] [Google Scholar]
- Barbara L., Sama C., Morselli Labate A. M., Taroni F., Rusticali A. G., Festi D., Sapio C., Roda E., Banterle C., Puci A. A population study on the prevalence of gallstone disease: the Sirmione Study. Hepatology. 1987 Sep-Oct;7(5):913–917. doi: 10.1002/hep.1840070520. [DOI] [PubMed] [Google Scholar]
- Barker D. J., Gardner M. J., Power C., Hutt M. S. Prevalence of gall stones at necropsy in nine British towns: a collaborative study. Br Med J. 1979 Dec 1;2(6202):1389–1392. doi: 10.1136/bmj.2.6202.1389. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bouchier I. A., Rhodes K., Brien M. A study of symptomatic and "silent" gallstone. Scand J Gastroenterol. 1968;3(3):299–304. doi: 10.3109/00365526809180604. [DOI] [PubMed] [Google Scholar]
- Braverman D. Z., Johnson M. L., Kern F., Jr Effects of pregnancy and contraceptive steroids on gallbladder function. N Engl J Med. 1980 Feb 14;302(7):362–364. doi: 10.1056/NEJM198002143020702. [DOI] [PubMed] [Google Scholar]
- Glambek I., Arnesjø B., Søreide O. Correlation between gallstones and abdominal symptoms in a random population. Results from a screening study. Scand J Gastroenterol. 1989 Apr;24(3):277–281. doi: 10.3109/00365528909093046. [DOI] [PubMed] [Google Scholar]
- Glambek I., Kvaale G., Arnesjö B., Søreide O. Prevalence of gallstones in a Norwegian population. Scand J Gastroenterol. 1987 Nov;22(9):1089–1094. doi: 10.3109/00365528708991963. [DOI] [PubMed] [Google Scholar]
- Gracie W. A., Ransohoff D. F. The natural history of silent gallstones: the innocent gallstone is not a myth. N Engl J Med. 1982 Sep 23;307(13):798–800. doi: 10.1056/NEJM198209233071305. [DOI] [PubMed] [Google Scholar]
- HORN G. Observations on the aetiology of cholelithiasis. Br Med J. 1956 Sep 29;2(4995):732–737. doi: 10.1136/bmj.2.4995.732. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hessler P. C., Hill D. S., Deforie F. M., Rocco A. F. High accuracy sonographic recognition of gallstones. AJR Am J Roentgenol. 1981 Mar;136(3):517–520. doi: 10.2214/ajr.136.3.517. [DOI] [PubMed] [Google Scholar]
- Janzon L., Aspelin P., Eriksson S., Hildell J., Trell E., Ostberg H. Ultrasonographic screening for gallstone disease in middle-aged women. Detection rate, symptoms, and biochemical features. Scand J Gastroenterol. 1985 Aug;20(6):706–710. doi: 10.3109/00365528509089199. [DOI] [PubMed] [Google Scholar]
- Jørgensen T. Abdominal symptoms and gallstone disease: an epidemiological investigation. Hepatology. 1989 Jun;9(6):856–860. doi: 10.1002/hep.1840090611. [DOI] [PubMed] [Google Scholar]
- Khuroo M. S., Mahajan R., Zargar S. A., Javid G., Sapru S. Prevalence of biliary tract disease in India: a sonographic study in adult population in Kashmir. Gut. 1989 Feb;30(2):201–205. doi: 10.1136/gut.30.2.201. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kingham J. G., Dawson A. M. Origin of chronic right upper quadrant pain. Gut. 1985 Aug;26(8):783–788. doi: 10.1136/gut.26.8.783. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lowenfels A. B., Walker A. M., Althaus D. P., Townsend G., Domellöf L. Gallstone growth, size, and risk of gallbladder cancer: an interracial study. Int J Epidemiol. 1989 Mar;18(1):50–54. doi: 10.1093/ije/18.1.50. [DOI] [PubMed] [Google Scholar]
- Mathieson J. R., So C. B., Malone D. E., Becker C. D., Burhenne H. J. Accuracy of sonography for determining the number and size of gallbladder stones before and after lithotripsy. AJR Am J Roentgenol. 1989 Nov;153(5):977–980. doi: 10.2214/ajr.153.5.977. [DOI] [PubMed] [Google Scholar]
- Maurer K. R., Everhart J. E., Ezzati T. M., Johannes R. S., Knowler W. C., Larson D. L., Sanders R., Shawker T. H., Roth H. P. Prevalence of gallstone disease in Hispanic populations in the United States. Gastroenterology. 1989 Feb;96(2 Pt 1):487–492. doi: 10.1016/0016-5085(89)91575-8. [DOI] [PubMed] [Google Scholar]
- Mellström D., Asztély M., Svanvik J. Gallstones and previous cholecystectomy in 77- to 78-year-old women in an urban population in Sweden. Scand J Gastroenterol. 1988 Dec;23(10):1241–1244. doi: 10.3109/00365528809090198. [DOI] [PubMed] [Google Scholar]
- Mok H. Y., Druffel E. R., Rampone W. M. Chronology of cholelithiasis. Dating gallstones from atmospheric radiocarbon produced by nuclear bomb explosions. N Engl J Med. 1986 Apr 24;314(17):1075–1077. doi: 10.1056/NEJM198604243141703. [DOI] [PubMed] [Google Scholar]
- Nomura H., Kashiwagi S., Hayashi J., Kajiyama W., Ikematsu H., Noguchi A., Tani S., Goto M. Prevalence of gallstone disease in a general population of Okinawa, Japan. Am J Epidemiol. 1988 Sep;128(3):598–605. doi: 10.1093/oxfordjournals.aje.a115007. [DOI] [PubMed] [Google Scholar]
- Pixley F., Wilson D., McPherson K., Mann J. Effect of vegetarianism on development of gall stones in women. Br Med J (Clin Res Ed) 1985 Jul 6;291(6487):11–12. doi: 10.1136/bmj.291.6487.11. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sampliner R. E., Bennett P. H., Comess L. J., Rose F. A., Burch T. A. Gallbladder disease in pima indians. Demonstration of high prevalence and early onset by cholecystography. N Engl J Med. 1970 Dec 17;283(25):1358–1364. doi: 10.1056/NEJM197012172832502. [DOI] [PubMed] [Google Scholar]
- Silman A. J. Age-sex registers as a screening tool for general practice: size of the wrong address problem. Br Med J (Clin Res Ed) 1984 Aug 18;289(6442):415–416. doi: 10.1136/bmj.289.6442.415. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thistle J. L., Cleary P. A., Lachin J. M., Tyor M. P., Hersh T. The natural history of cholelithiasis: the National Cooperative Gallstone Study. Ann Intern Med. 1984 Aug;101(2):171–175. doi: 10.7326/0003-4819-101-2-171. [DOI] [PubMed] [Google Scholar]
- Wolpers C. Veränderungen an "stillen" Gallenblasensteinen. Röntgendiagnostische und symptomatologische Beobachtungen über 30 Jahre. Dtsch Med Wochenschr. 1986 Aug 1;111(31-32):1186–1191. doi: 10.1055/s-2008-1068605. [DOI] [PubMed] [Google Scholar]