Hormone Replacement & Gallbladder Disease: October 10, 2013

Kellie Crowley’s gallbladder problems had likely been brewing for years. But as far as she knew, it struck overnight. The symptoms came on suddenly.

“At first the pain was radiating. I wasn't sure if I was having a heart attack or what was happening, and I ended up in the ER,” says Crowley.

“Many people feel if we live long enough we’re all going to get gallstones,” says Dr. Barry Haicken, general surgeon with Lee Memorial Health System.

Dr. Barry Haicken removed Crowley’s diseased gallbladder. About a half-million people undergo the surgery each year. The gallbladder stores and releases bile which helps digest fats. There are several reasons why gallstones form. Risk factors are highest in women.

“Women tend to get gallbladder disease much more than men. So the biggest risk factor would be a woman. Probably 80-90% of my patients for gallbladder disease are women,” says Dr. Haicken.

When it relates to gallstones, it often comes down to the 3 ‘W’s: women, white and weight. All three are linked to high rates of gallbladder disease.  Asians and African-Americans have a lower risk, and studies show the use of hormone replacement therapy, or HRT, may double or triple risk.

“I wouldn't be surprised. I had a hysterectomy several years ago so if it has to do with hormone replacement I probably would be a candidate,” says Crowley.

“The exact connection remains elusive. Obviously estrogen and progesterone are going to play a part in that differentiation, but exactly what it is nobody knows,” says Dr. Haicken.

How the hormones are delivered may make a difference, however. Women who use a patch or gel form of HRT face less risk than those who take a pill. Again, not all gallstones create a problem. If patients have frequent or several gallbladder attacks; surgery may be in order.

“Your body does very nicely without the gallbladder. The bile instead of coming out in a big gush after a meal now drips in steadily all day long and the digestion is essential normal,” says Dr. Haicken.