Diet
Dietary recommendations in gallbladder disease differ according to the stage of disease. The 2 available strategies include acute management and preventive measures. The patient with acute cholecystitis should ingest nothing by mouth (NPO) and undergo nasogastric evacuation of gastric contents. The goal in this stage of disease is to eliminate unnecessary stimulation to the biliary system and to reduce infectious exposure. Additionally, preparations can be more readily made for surgery.
No widely accepted dietary therapy exists for the prevention of cholecystitis; however, the contemporary Western diet and obesity have been implicated as predisposing factors in the development of gallstone disease. Certainly, diet and exercise are influential, and the West is infamous for poor dietary and exercise habits.
Results from a Jamaican cohort study by Walker et al indicated a link between diet and cholecystitis. The authors examined a population of patients with sickle cell disease similar to that examined by Winter et al in the United States. The progression of biliary sludge to cholecystitis and the need for cholecystectomy was significantly decreased in the Jamaican population. Walker et al theorized that dietary differences in the 2 countries were causal. These cultural influences affect the adolescent and adult populations.[23]
Presumably, a decrease in cholesterol and fatty food consumption would lower the risk of cholecystitis, but no specific data supporting this have been collected. Dietary restriction to achieve weight reduction may minimize risk in children with obesity. Weight loss should be controlled and gradual, because rapid reduction may increase bile cholesterol saturation and gallbladder stasis, actually promoting stone formation.
Dietary management of chronic gallbladder disease in the absence of surgery also follows this preventive approach, with the added goal of preventing symptoms. Although biliary colic in children is less likely to directly correspond to fatty food consumption than it is in adults, the patient should still be advised to avoid high-fat meals.
Finally, in patients with hyperalimentation-associated gallstones, administer low-dose enteral feedings, which may prevent stone formation by stimulating contraction of the gallbladder and reduction of bile stasis.
DietDietary recommendations in gallbladder disease differ according to the stage of disease. The 2 available strategies include acute management and preventive measures. The patient with acute cholecystitis should ingest nothing by mouth (NPO) and undergo nasogastric evacuation of gastric contents. The goal in this stage of disease is to eliminate unnecessary stimulation to the biliary system and to reduce infectious exposure. Additionally, preparations can be more readily made for surgery.No widely accepted dietary therapy exists for the prevention of cholecystitis; however, the contemporary Western diet and obesity have been implicated as predisposing factors in the development of gallstone disease. Certainly, diet and exercise are influential, and the West is infamous for poor dietary and exercise habits.Results from a Jamaican cohort study by Walker et al indicated a link between diet and cholecystitis. The authors examined a population of patients with sickle cell disease similar to that examined by Winter et al in the United States. The progression of biliary sludge to cholecystitis and the need for cholecystectomy was significantly decreased in the Jamaican population. Walker et al theorized that dietary differences in the 2 countries were causal. These cultural influences affect the adolescent and adult populations.[23]Presumably, a decrease in cholesterol and fatty food consumption would lower the risk of cholecystitis, but no specific data supporting this have been collected. Dietary restriction to achieve weight reduction may minimize risk in children with obesity. Weight loss should be controlled and gradual, because rapid reduction may increase bile cholesterol saturation and gallbladder stasis, actually promoting stone formation.Dietary management of chronic gallbladder disease in the absence of surgery also follows this preventive approach, with the added goal of preventing symptoms. Although biliary colic in children is less likely to directly correspond to fatty food consumption than it is in adults, the patient should still be advised to avoid high-fat meals.Finally, in patients with hyperalimentation-associated gallstones, administer low-dose enteral feedings, which may prevent stone formation by stimulating contraction of the gallbladder and reduction of bile stasis.
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