Tag Archive for: gallbladder

Exploding Gallbladders: Just the Facts

Let’s take a look at the actual case study on the exploding gallbladder and figure out what’s relevant and what’s conjecture—by all parties.

The Case Study

The paper was the result of a close examination of the medical information gathered when a 69-year-old man went to the emergency room at SUNY Brooklyn Medical Center with a perforated gallbladder. There were three parts to the paper:

  • The introduction focused on curcumin and its potential for causing issues in people with gallbladder disease.
  • The second described the treatment plan for the patient, mostly antibiotics and pain relievers.
  • Finally, a review laid the groundwork for why curcumin caused the perforation in the gallbladder.

The reason? Curcumin may increase the strength of the contractions in the gallbladder duct as it moves bile. A large stone was blocking the duct, so curcumin caused the pressure to buildup in the gallbladder and boom: explosion! Well, perforation, but you get the idea.

The Problem

There was no evidence to show that curcumin directly contributed to the gallbladder issues. What was also in the case study but not considered was that the patient had a history of gallstones. He was also taking five medications for hypertension, high cholesterol, and an enlarged prostate.

The writers of the case study were a medical student and a nephrologist (a kidney specialist). Based on published information, neither was an expert in the digestive system. It appears to have been conjecture on their part as to the cause of the gallbladder perforation. The comments on food and supplement oversight, while referenced, did not demonstrate any understanding of the FDA’s oversight of food and supplements; they’re not controlled as pharmaceuticals are, but both the FDA and FTC have control over the claims they can make. The amount of curcumin used by the patient was within the standard range for use of the supplement.

The Bottom Line

I can’t fault the writer for the Daily Mail; writers sometimes tend toward the sensational, and an exploding gallbladder is a perfect fit. The physicians and the article reviewers should have realized the faults in the analysis. Could a gallbladder explosion have been possible? Yes, but without accounting for the current status of the patient’s disease and considering pharmaceutical interactions of the meds the patient was taking, they used the “Ready, Fire, Aim” approach to assess what might have happened. We might expect that from reporters with no health background but not from medical professionals.

They were right about one thing. More research on interactions between food, herbs, and pharmaceuticals is necessary—but that isn’t news.

What are you prepared to do today?

        Dr. Chet

References:
1. http://bit.ly/3KikdPv
2. American Journal of Medical Case Reports, 2022, Vol. 10, No. 12, 311-313

Exploding Gallbladders!

Health Memo readers frequently forward health-related articles to me to ask my opinion; I read them all and respond to the sender if asked. Combined with my health news feeds, I read a lot about health—opinions about health, that is. I’m going to share a couple with you in the next few Memos and—wait for it—give you my opinion about whether what is being said is accurate, and more important, meaningful.

Let’s begin with curcumin, a very popular dietary supplement and a component of the herb turmeric used in cooking. It’s generally used as an anti-inflammatory for a variety of conditions, including joint health. The health headline in the Daily Mail implied that a 69-year-old man’s gallbladder exploded due to the interaction of the gallstones in his gallbladder with the high doses of curcumin he was taking. The Daily Mail seems to focus on celebrity news more than other types of news, but that doesn’t mean we can ignore the story.

The Daily Mail article was based on a case report published in a journal focused on just such case studies. The reporter took language from the paper that suggested that supplements avoid the regulatory process, creating a set of circumstances that could be potentially dangerous, as in this case. It also suggested that adverse reports with supplements are not reported. Is that all true? More importantly, what are the implications of such an article? I’ll let you know on Saturday.

What are you prepared to do today?

        Dr. Chet

References:
1. http://bit.ly/3KikdPv
2. American Journal of Medical Case Reports, 2022, Vol. 10, No. 12, 311-313