 My name is Jean and I'm a surgeon specializing in the management of acute care conditions. What are those? Well, those are conditions that need urgent surgical care. We can't wait for next week to do your surgery. We need to do it right now. So you've just had an ultrasound and it shows gallstones. What are they? What causes gallstones? And what can you do to prevent getting gallstones? So as the name implies, these are just stones and they develop in the gallbladder. The gallbladder contains bile, a very thick viscous fluid and under the right circumstances stones can form in that very thick fluid. If we look globally, we find that about 9% of women and about 6% of men develop gallstones. Well there are three types of gallstones. The most common one is a cholesterol stone and worldwide they make up about 75% of all cases. Now as the name implies, these are full of cholesterol but there's also some calcium and bile salts in there. The second most common stone is a black pigment stone that makes up about 25% of all cases. It's really particular though in patients who've got abnormalities of their red blood cells. The least most common gallstone is the brown pigment stone and we see that only in about 5% of cases. That really has to do in patients who've had specific parasitic and bacterial infections of their gallbladder or in patients who've had manipulation of their biliary tree. Very rarely we'll also find it in the biliary tree after the gallbladder has been removed. So what are your risk factors for developing gallstones? Well, some of them you can do nothing about and the first one is age. The older you are, the higher your risk of developing gallstones and we really see a peak incidence in patients in their 50s and in their 60s. Gender is also very important and it's more common in women than in men. Over 50 it goes down to about 2 to 1. Genetics play a very important role. If we look at identical twins, we'll see that if one twin has gallstones about 25% of their siblings will have gallstones as well. And if your parents have gallstones, you have about a 15% risk of developing gallstones. Unfortunately pregnancy is also a risk factor. It changes the constituency of bile and it also delays the emptying of the gallbladder. Under these conditions we increase the likelihood of the development of stones. What about high cholesterol levels? We get cholesterol stones don't we? Well we see patients with very high cholesterol levels and they don't have stones. Or patients with stones and they don't have high cholesterol level. There isn't a direct correlation between the two. There are studies who've looked at patients with diabetes and they seem to have a higher incidence of gallstones. Some studies though show that that's particular to women. Obesity is a real risk factor that's been well established. More importantly is rapid weight loss. So patients who are on a very strict diet, less than 800 calories per day or patients who've had gastric bypass surgery, they tend to develop gallstones. The last one I want to mention is hormone replacement therapy. Any kind of high levels of estrogen that's taken in, whether that be for women or for men, that will increase your risk for the development of gallstones. So what can you do to prevent getting gallstones? Well one of the substances that have been researched quite a bit is vitamin C. So if you take vitamin C regularly your risk goes down. The next is your diet. Now polyunsaturated fats and monounsaturated fats, as you would find in nuts, they will really decrease your incidence of the development of gallstones. One of my personal favorites of course is coffee. And there's this direct line between the two. The more coffee you drink the lower your risk for the development of gallstones. Now I'm a good healthy fit vegan and fortunately being a vegan and taking in plant protein that lowers your risk too. And then there's my absolute favorite. Of course the last way to prevent gallstones is physical activity. Now this is a beautiful 10 kilometer run down C Point in Cape Town. Wherever you live I encourage you to do your exercise as well to prevent getting gallstones. So I hope you've enjoyed this video. I hope that you've found it helpful. If you did please subscribe and hit that notification bell so that when new videos come out you're the first one to know about it.