Affecting around five out of 1,000 people, hemochromatosis is one of the most common genetic disorders in the United States, according to the United States Department of Energy Biological and Environmental Research. Many persons with hemochromatosis don't realize they have this disorder, which causes an overload of iron stores in your body due to excessive absorption of iron. If untreated, hemochromatosis can lead to serious liver disease, called cirrhosis, which can cause gallstone formation.
Definition
Hemochromatosis affects men more often than women, probably because women lose blood during menstruation, which lowers their iron stores. Symptoms normally develop in men between the ages of 30 and 50 and after age 50 in postmenopausal women. Liver abnormalities, heart disease, arthritis, a bronze or gray coloration to the skin, diabetes from damage to the pancreas and thyroid or adrenal gland damage can occur. Liver damage from hemochromatosis can progress to cirrhosis, or scarring of the liver. Having cirrhosis of the liver doubles your risk of having gallstones, gastroenterologist Frank Jackson, M.D., explains.
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The liver produces bile, a substance that helps break down fat and aids in digestion in the small intestine. Cirrhosis interferes with normal bile metabolism, which can lead to gallstone formation. Cirrhosis can also interfere with bile flow to and from the gallbladder, leading to gallstone formation.
Types of Stones
Around 80 percent of gallstones contain cholesterol, according to the National Institute of Diabetes and Digestive and Kidney Diseases. The gallstones that form if you have cirrhosis, called pigment gallstones, contain mostly bilirubin, a waste product of bile. Excess amounts of bilirubin can harden into small, dark gallstones.
Surgery
If you have compensated cirrhosis, meaning that you haven't yet developed complications from the disease, you can have gallstones removed surgically. A meta-analysis of six studies conducted by researchers from the University of Hawaii and published in the December 2003 issue of "Journal of the American College of Surgeons" found no increase in mortality rates compared to the general population. However, complications such as bleeding from the liver and development of complications related to cirrhosis such as ascites, abdominal fluid retention, did increase, with 21 percent of patients with cirrhosis experiencing complications compared to 8 percent of patients without cirrhosis. If you have more advanced cirrhosis, the risk of surgery may be too high, Charles Bellows, M.D., and colleagues reported in the August 2005 issue of "American Family Physician."
References
- Jackson/ Siegelbaum Gastroenterology; Cirrhosis; Frank Jackson, M.D.
- National Institute of Diabetes and Digestive and Kidney Diseases; Gallstones; July 2007
- National Institute of Diabetes and Digestive and Kidney Disease; Cirrhosis;December 2008
- U.S. Department of Energy Biological and Environmental Research; Hereditary Hematochromatosis; December 2002
- "American Family Physician"; Management of Gallstones; Charles Bellows, M.D., et al.; August 2005
- "Journal of the American College of Surgeons"; A Metaanalysis of Laparoscopic Cholecystectomy in Patients with Cirrhosis; A. Puggioni, et al.; December 2003
