ELI5: Fat, Forty, and Female and the Gallbladder

Did you know that gallbladders will most frequently act up (ie, cholecystitis) in female patients who are between 40 and 60 years old and are overweight?

(We'll get to the other two F's later.)


What does the gallbladder do anyway?

(Let me give you the understanding necessary for NCLEX and no more!)

The gallbladder is a unique and fascinating organ that acts as a storage facility for bile. It does NOT make the bile. Really. I think this is a common misconception. It stores bile and then, when a person eats a meal with fat, it releases the bile into the GI tract to digest the fat. It's supposed to only release as much as is needed to digest the fat and no more.

Sometimes, though, our gallbladder develops a stone (composed of various minerals or otherwise) or becomes inflamed/infected or is simply doing a poor job by releasing too much or too little bile at the wrong times. This will cause various digestive issues when the person eats a high fat meal. If too little bile is released, the person will have clay colored stools, because guess what makes poop a brown color? BILE!

When a faulty gallbladder is removed, the body is at first confused about where to store bile. Eventually, it figures out that that storage facility (the gallbladder) has been removed and begins to output a normal amount of bile directly into the intestines themselves without the gallbladder interfering at all. That's why we can live without one!

Some people do better without a gallbladder than others, however. Many people report continued complications when they eat a high fat meal. Others report being able to return to their normal eating habits in as little as six weeks after a cholecystectomy (gallbladder removal).

Anyway, back to the title: fat, forty and female. These factors are the ones I was told in nursing school that are commonly linked to gallbladder problems. A more detailed search reveals five F-words (none that famous one!) of factors linked to cholelithiasis (stones in the gallbladder):

-fat (BMI > 30)


-forty (age > 40 y/o)

-fertile (non-menopausal)

-fair (light-skinned type)

In fact, in this article, it's argued that the mnemonic should be changed. Rather than including > 40 years of age, which was not statistically supported, the study argues that family history should be the fifth F. When compared to a control of 13.5% who have a first-degree relative with history of gallbladder issues in the general population, 39.4% who develop cholelithiasis have a first-degree relative with history of gallbladder issues. Pretty statistically significant.

#gallbladdersm #cholelithiasis #cholecystectomy

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