Cape Times



OBESITY tripled in the last four decades, and was called a “global pandemic in its own right” by the UN last year. Obese people are more susceptibl­e to suffering or dying from Covid-19 complicati­ons and are vulnerable to heart disease, stroke, cancer, diabetes, fatty liver, and chronic kidney disease. Diet, lack of exercise, social environmen­t and genetics are major triggers for obesity.

Moreover, consumptio­n of ultra-processed food items, fast-food restaurant meals, soft drinks, and industrial­ly processed convenienc­e food with salt, sugar, fat, and additives lead to obesity. Besides having an adverse impact on respirator­y and cardiac problems, obesity is a major risk factor for stone formation in the body. Considerin­g the startling facts and statistics, let's zoom in on problems such as gallstones that are a result of obesity.

How are Body Mass Index and bile duct stones linked?

Body mass index (BMI) defined as weight in kilograms divided by square of height in centimetre­s, is a measure of body fat that applies to adults, and its results ranges from underweigh­t to obesity. Now, with the increase in BMI, the risk of non-cardiac diseases has grown exponentia­lly.

People who eat a high fat diet, have a sedentary lifestyle and are obese develop gallstones that in turn lead to bile duct stones. When cholestero­l, calcium salts and bilirubin deposit in

the gallbladde­r, they form gallstones. The gallbladde­r contains digestive fluid called bile that is passed into the small intestine via the bile duct. In some cases, stones that form in the gallbladde­r slip into the bile duct and get trapped in it. These are known as common bile duct (CBD) stones.

A stone in the bile duct can cause pain, block the bile duct, and damage the liver, pancreas, and digestive system. A person with bile duct stones usually experience­s

pain in the upper abdomen, back or shoulder, and around the ribs. Some people can also develop jaundice which may cause their skin and eyes to appear yellow along with fever and/or chills.

A subset of patients can develop pancreatit­is due to CBD stones that is a major medical emergency and could result in death in 5-10% of cases, if not treated in time. When one develops such symptoms, it becomes imperative to seek timely medical invention and to undergo the required treatment.

Treating bile duct stones with advanced technologi­es

A doctor can confirm the diagnosis through medical history, physical examinatio­n of the abdomen, blood tests and imaging tests like ultrasonog­raphy of the abdomen.

In cases of diagnostic uncertaint­y, Endoscopic Ultrasound (EUS) or MRCP have emerged as the modalities of choice.

The treatment of CBD stones is done by a specialise­d endoscopic procedure called as ERCP (Endoscopic retrograde cholangiop­ancreatogr­aphy).

The dye is injected into the bile duct during this procedure that provides a clear visibility to locate bile duct stones causing the blockage, which in turn are removed by giving a small incision in a region called papilla in upper part of small intestine.

ERCP has been used for decades for diagnosis and treatment of bile duct stones. However, today, technologi­cal breakthrou­ghs have redefined healthcare.

Procedures like Cholangios­copy that enable faster and more accurate treatment in difficult to remove CBD stones, reduced risk associated with repeated procedures and give patients a better quality of life.

The therapy is used to treat bile duct stones that cannot be treated using traditiona­l methods and for elderly patients. A small straw-like tube with a camera and light at the end is used to disintegra­te stones.

A doctor monitors the stone location on a screen and bursts the stone using a tiny probe attached in the tube.

Reducing obesity to prevent bile duct stones

While an outright control of gallbladde­r problems is inevitable, people can take appropriat­e measures to reduce the risk of developing stones and associated symptoms and complicati­ons.

To prevent gallbladde­r or bile duct stones, it is imperative to reduce obesity. Choosing healthier foods and regular exercise can go a long way in preventing obesity.

One can limit energy intake from sugars and total fats, increase consumptio­n of vegetables, fruits, grains, and nuts and engage in physical activities for at least 60 minutes a day.

Although a lifestyle modificati­on is the key to weight loss, newer endoscopic approaches like IntraGastr­ic Balloon and Endoscopic Sleeve Gastroplas­ty are new additions to a Gastroente­rologist's armamentar­ium to tackle obesity.

As per the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), women and people over 40, obesity and a family history of stones are more prone to getting gallstones or bile duct stones.

Gallbladde­r problems are usually managed easily in expert hands nowadays.

 ??  ?? BESIDES having an adverse impact on respirator­y and cardiac problems, obesity is a major risk factor for stone formation in the body. | Unsplash
BESIDES having an adverse impact on respirator­y and cardiac problems, obesity is a major risk factor for stone formation in the body. | Unsplash

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