Recovery time usually involves 5–7 days in the hospi-
tal and several weeks at home.
Some people are not healthy enough to undergo
surgery. In this case, treatment options include a med-
ication called ursodiol (Actigall) that helps dissolve
cholesterol stones. However, the dissolving process
can take 6ndash;18 months. Sometimes this drug is
given to people going on medically supervised very-
low-calorie diets for fast weight loss to help prevent
them from developing gallstones. The other nonsurgi-
cal treatment option is sound wave therapy (extracor-
poreal shock wave lithotripsy). High-frequency sound
waves are aimed at the gallstones to shatter them into
smaller pieces. The pieces are then dissolved using the
ursodiol. With nonsurgical treatment gallstones often
reoccur. When the patient is healthy enough for sur-
gery, gallbladder removal is usually the preferred
option.
Nutrition/Dietetic concerns
Once recovery from surgery is complete, individ-
uals who have had their gallbladder removed can
return to a normal healthy diet.
Prognosis
Gallbladder surgery is quite safe, although all
surgery carries risk of infection, reaction to anesthesia,
and unintentional damage to other tissue. Once the
gallbladder is removed, no more gallstones can form.
Most complications from gallstones arise when treat-
ment is delayed and the pancreas or gallbladder
becomes infected. This is a serious, potentially fatal,
complication because infection can spread rapidly and
overwhelm the body. Gallstone disease is responsible
for about 10,000 deaths in the United States each year,
of which only a few hundred are caused by surgical
complications. The vast majority are caused by gall-
stone disease that has caused infection.
Prevention
The formation of gallstones cannot be prevented.
However maintaining a healthy weight, exercising reg-
ularly, and eating a diet high in whole grains and fresh
fruit and vegetables and low in fat and cholesterol
decrease the chance that gallstones will develop.
Resources
ORGANIZATIONS
American College of Gastroenterology. P.O. Box 342260
Bethesda, MD 20827-2260. Telephone: (301) 263-9000.
Website:<http://www.acg.gi.org>
American Gastroenterological Association. 4930 Del Ray
Avenue, Bethesda, MD 20814, Telephone: (301) 654-
- Website:<:http://www.gastro.org>
Weight-control Information Network (WIN). 1 WIN Way,
Bethesda, MD 20892-3665. Telephone: (877)946-4627
or (202) 828-1025. Fax: (202) 828-1028. Website:
http://win.niddk.nih.gov
OTHER
Faye, Maryanne L. and William K. Chiang. ‘‘Cholelithia-
sis.’’ eMedicine.com, June 12, 2006.http://www.
emedicine.com/emerg/topic97.htm
Heuman, Douglas M. and Anastasios Mihas. ‘‘Cholelithia-
sis.’’ eMedicine.com, August 2, 2006.http://www.
emedicine.com/med/topic836.htm
Mayo Clinic Staff. ‘‘Gallstones.’’ MayoClinic.com, July 25,
2005.<http://www.mayoclinic.com/healthgall stones/
DS00165/>
Raboff, William K. ‘‘Gallstones.’’ eMedicineHealth.com,
August 10, 2005.http://www.emedicinehealth.com/
gallstones/article_em.htm
Weight-control Information Network (WIN). ‘‘Dieting and
Gallstones.’’ National Institute of Diabetes and Diges-
tive and Kidney Diseases, April 2006.http://win.
niddk.nih.gov/publications/gallstones.htm
Tish Davidson, A.M.
Gastroesophageal reflux
disease
Definition
GERD, or gastroesophageal reflux disease, occurs
when gastric juice from the stomach backs up into the
bottom of the esophagus and causes irritation, inflam-
mation or erosion of the cells lining the esophagus.
GERD is sometimes called acid reflux disease.
Description
The esophagus carries food from the mouth to the
stomach. A ring of strong muscle called the lower
esophageal sphincter (LES) is located at the spot
where the esophagus enters the stomach. The LES
relaxes and opens when a person swallows, allowing
food to enter the stomach. The LES stays closed in
healthy people the rest of the time, preventing the
contents of the stomach from backing up into the
esophagus. In people with GERD, the LES is weak
and opens at inappropriate times, allowing a back-
wash of stomach contents into the bottom part of the
esophagus.
Gastroesophageal reflux disease