Browse through this article, which came to me in my health plan's newsletter. See if you can find any inconsistancies, and just plain errors. Try to separate facts (often mis-applied) and statements of preference/recommendations/strategy.

GALLSTONES: To treat or not to treat? by Kitima Lanzefame, MD - surgeon

Q: I thought gallstones always needed surgery. Can they be left alone?

A: Gallstones are very common in America. Linked to high-fat diets and obesity, as well as rapid weight loss, they are stone-like material formed from bile and other chemicals inside the gallbladder. The gallbladder is tucked away under the liver just below the right rib cage.

Overweight women 40 and older are at greatest risk for gallstones, which tend to run in families. Native Americans are more prone than whites, and whites more so the African-Americans. The risk increases with age. By age 75, one-third of all women and one-fifth of all men will develop gallstones. However, just because you have them doesn't mean you will have symptoms. Many people never experience any problems, and do not need treatment.

Symptoms do occur when gallstones block the flow of bile from the gallbladder, which stores the bile, to the intestine. Bile is a liquid that helps digest fats, and gallstone attacks often follow fatty meals and can last from two to five hours. About 30 minutes to an hour after eating, pain starts at the top of the abdomen, right below the breastbone, and then radiates to the back or right quadrant of the torso.

With gallstone attacks or more severe complications (see box at left), the treatment of choice is removal of the gallbladder. Other treatments - drugs that dissolve gallstones or lithotripsy (shock waves) that break up the stones - are only short term fixes. Then the gallstones recur.

The most common question I hear is, "Can I live without a gallbladder?" Yes, absolutely. Because the gallbladder is an organ of storage, the bile will simply drain directly from the live through the bile ducts into the small intestines. The surgical removal of the gallbladder is very successful; only about 10 percent of patients experience some diarrhea lasting for a month or two.

Nothing in medical research indicates that you can prevent or lessen gallstones once you have them. For young people with a family history of gallstones, I recommend a low-fat diet and keeping fit and trim.

It is not strange that a surgeon would be consulted on many acute gallstone attacks, as a surgical procedure is likely to be required to clear the inflamed and blocked bile duct. The gallstone is too big, and if it isn't dislodged, the patient will die.

However, in many cases the gallstone is not big enough to cause the blocking of the bile duct. Most of the pain associated with gallstones is caused when a sharp (most are) gallstone cuts tissue in the bile duct, leaving no stone, but creating a wound.

The article is right that once you have gallstones, you generally don't get rid of them except by "passing" them. So, just because an incident (mild attack) is over, or a procedure dislodged or broke up the particular stone that blocked the bile duct, this does not mena you're done with gallstones. There are likely others that have not shaken loose from the resting place in the gallbladder. Therefore, a plan for the coping with or removal of the gallstones from the gallbladder is essential.

Dr Atkins relates that gallstones result from "billiary stasis". When the bile is not required for long periods of time (like during extreme low fat dieting), the bile system is stationary, and crytalline structures (stones) form. It is true that if your body has constant need for bile (to digest fat), you'll not form any stones.

So, why the surgeon suggests low fat eating for people with family backgrounds of gallstones truly escapes reason.

My experience is that gallstones like fat. They do not like being starved, or fed low fat crapola.

I have been on low fat diets all my life, and suffered from gallstones for the last ten years. I mean really suffered - emergency room at the weekends etc etc.

Not since adopting a low CARB diet. All pain, all symptoms JUST GONE. I have taken myself off the surgery list. The doctor considered it a miracle until she read up, and then concluded, erm low carb is erm well actually very sound science. Who would have thunk it?

Eat fat. Lose gallstones.

Good luck everybody,

Jilly