Prevalence and Risk Factors of Symptomatic Gallbladder Stone Disease Using Ultrasonography

Abstract

Background: Diseases of the gallbladder are common and its management is costly. The best epidemiological screening method to accurately determine point prevalence of gallstones disease is ultrasonography. Symptomatic gallstones present with characteristic right upper quadrant discomfort or pain (biliary colic).Many risk factors for cholesterol gallstones formation are not modifiable such as ethnic background, increasing age, female gender and family history or genetics. Conversely, the modifiable risks for cholesterol gallstones are obesity, rapid weight loss and a sedentary lifestyle. The rising epidemic of obesity and the metabolic syndrome predicts an escalation of cholesterol gallstones frequency. Worldwide risk factors for biliary sludge include pregnancy, drugs like ceftiaxone, octreotide and thiazide diuretics, and total parenteral nutrition or fasting. Diseases like cirrhosis, chronic hemolysis and ileal Crohn's disease have been identified worldwide as risk for black pigment stones. The risk factors associated with gallstones in the Ghanaian context is however yet to be determined. Aim: The aim of this research study was to determine the prevalence and risk factors of symptomatic gallstones among Ghanaian patients in three hospitals in Accra. Methods: Using a quantitative cross sectional method, 100 patients aged more than 20 years were enrolled by convenient sampling method in April 2014 .They answered questionnaire pertaining to symptoms of gallstones, diet and environmental factors. Subsequently ultrasonography was performed in all the 100 participants with right upper quadrant abdominal pains using Toshiba Aplio 300 ultrasound scanner with a curvilinear transducer of frequency 5.0 MHz, 2005 make. The data was analyzed using SPSS version 13.

Results: Ultrasonography revealed a 42% prevalence of gallstones at the selected hospitals. Chi-square test revealed a significantly increased risk of gallstones in females aged between 20-30years, 60-70years with multiparity status and a clinical history of right upper quadrant abdominal pains. An increased risk was revealed in diabetic males who drank unpurified water. Conclusion: A strong association was discovered between high cholesterol diet intake and gallstones disease. The study further revealed high prevalence of gallstones in females (47.2%) than males (28.6%).This finding is agreeable with most published literature which indicated female: male ratio of almost 2:1.