I'm gonna shift gears now and we're gonna talk about the risk factors for gallstones
from the perspective of a nurse and a patient advocate.
These are risk factors that I want you to understand
so that you can educate and advocate for your patients.
Now, I developed them into three big categories
and the one I wanna start with first is most personal, but it's most modifiable.
We're gonna talk about lifestyle risk factors.
Now, you need to approach this conversation with caution
because people can be very sensitive about this,
but as long as you treat them with respect, make eye contact,
and don't act judgemental, they're gonna appreciate your honesty and interaction.
So, the first one, being overweight or obese increases your risk for gallstones.
There's also other risk factors with go -- with obesity,
but we're gonna focus on the risk for developing gallstones.
How this works is obesity causes an increased secretion of cholesterol in the bile.
We know that most gallstones, like up to 80%, are cholesterol-based.
So, we wanna educate our patient about practical lifestyle changes.
Changes to their diet. Things like if they're eating a diet that's high in fat or cholesterol
and low in fiber, we kinda wanna flip those ratios.
We need them to lower their fat and cholesterol intake in their diet and increase their fiber.
Now, the third one is having rapid weight loss.
You would think that this would be a positive thing and it is for some other risk factors,
but here's what it does to your gallbladder.
Remember what stimulates your gallbladder to contract and release the bile?
Right, it's food. Particularly fat and protein when it hits your small intestine.
Well, if someone has had rapid weight loss, often times,
they've severely restricted their diet, almost eliminated fat.
Okay, so they're not getting the regular stimulation for that gallbladder to empty out.
That means that bile is sitting in there for long periods of time
which can turn into sludge or stones that end up blocking the hepatobiliary system.
Now, the last one, number four, ties right back up to number one.
We know one of the biggest risk factors for developing type II diabetes is being overweight or obese.
So, one and four are the really big opener and closer,
but if you can help the patient be bought into changing those things,
you can really impact their overall health, not just gallstones.
So, there's lifestyle risk factors that can be modified so it's our role to have appropriate,
professional, and therapeutic communication with our patients regarding these risk factors.
Second category are uncontrollable risk factors.
You can't change any of these things about your patient.
Being female, being Native American or Mexican American,
having a family history of gallstones, or being 60 years of age or older.
They just are what they are.
Now, let's take a look at medical risk factors.
I want you to know that having cirrhosis or sickle cell increases your odds,
but really can't make the direct connection for your as why, but 30-50% of people
with sickle cell disease will develop gallstones.
Now, there's some other medical risk factors like being pregnant.
That doesn't seem fair either, does it?
Taking certain medications that lower cholesterol
or taking medications that have a high estrogen content.
Any one of these four circumstances will also increase your patient's risk for developing gallstones.
In this section of the video series, we're gonna talk about the risk factors
that are unique to women for developing gallstones.
Now, keep in mind, oral contraceptives affect cholesterol production
so if someone is taking an taking oral contraceptive,
this will increase the likelihood of their gallbladder cholesterol saturation.
So, that sounds like a very awkward way to say it, but let me break it down for you.
If I'm a female who's taking oral contraceptives to prevent getting pregnant,
I'm gonna have increased cholesterol, right? In my bile.
That's not a good thing because if it gets so high that I'm over saturated,
I'm increasing my likelihood of developing a gallstone.
Now, postmenopausal women who are in estrogen replacement therapy
also have an increased risk, as do females who have multiple pregnancies or are over 40 years of age.