Gallbladder is a part of gastrointestinal system, which function is to store and release bile into the digestive system. Bile is a substance that helps us to digest fats. Gallstones (also known as gallbladder stones or cholelithiasis) are deposits of crystalized bile in the gallbladder. There are two types of gallstones, which are cholesterol gallstones and pigmented (bilirubin) gallstones. This article will primarily focus on the more common cholesterol gallstone.
胆囊是人体消化系统的一部分，主要负责储存和排放胆汁，协助脂肪的分解与吸收。所谓胆结石（又称胆囊结石或胆石症）是指胆汁在胆囊中发生异常沉淀，逐渐形成的固体结晶。根据不同的成分，胆结石可分为胆固醇结石和色素结石（主要由胆红素构成）两类。本文将重点介绍更为常见的胆固醇结石。
Cholesterol gallstone typically occurs when there is an overproduction of cholesterol in the liver and excessive secretion of the cholesterol to the bile, causing the bile to become saturated, leading to formation of crystal stones. There are various factors that can cause gallstones, which include increased production of bile, excess cholesterol secretion from the liver, concentrated bile, faster cholesterol crystallization and reduced gallbladder activity.
胆固醇结石通常是由于肝脏中过量产生胆固醇，并将其过量分泌至胆汁中，导致胆汁饱和，从而形成结晶石。多种因素可能导致胆结石的形成，包括胆汁的过度分泌、肝脏胆固醇分泌过量、胆汁浓缩、胆固醇结晶的加速以及胆囊活动功能减弱等。
The formation of gallstone is influenced by various factors including age, gender, genetic, medical conditions, medications, dietary intake, and physical activity. Typically, gallstones are asymptomatic, and treatment is not necessary. However, they may lead to complications such as obstruction of bile duct, inflamed gallbladder, pancreas or bile duct, jaundice, liver infection, and rarely gallbladder cancer. In such cases, surgical intervention might be needed.
胆结石的形成受多种因素影响，包括年龄、性别、基因、健康症状、药物使用、饮食摄入和身体活动水平。大多数胆结石患者并无明显症状，通常无需治疗。但在部分情况下，胆结石可能引发一系列并发症，如胆管梗阻、胆囊炎、胰腺炎、胆管炎、黄疸、肝脏感染，甚至在极少情况下发展成胆囊癌。遇此类并发症时，往往需通过外科手术进行处理。
General healthy eating can help to prevent gallstones. In people already with gallstones, it may help in symptoms management. However, it cannot reverse gallstones. While there is no specific diet for this disease, here are some changes that can be considered:
均衡健康的饮食有助于预防胆结石的发生。对于已确诊胆结石的患者，合理饮食虽无法消除已形成的结石，但有助于缓解相关症状，减少发作频率。目前尚无针对胆结石的特定治疗性饮食，但可参考以下饮食调整建议：
- Avoid trigger food
避免诱发性食物
Some food can irritate the gastrointestinal system, triggering pain of the gallbladder. This includes fatty food, sugary food, spicy food, carbonated drinks, and caffeine. Patients with gallstones can try to avoid these foods to reduce pain due to gallstones.
某些食物可能刺激胃肠道，诱发胆囊收缩，从而引起或加重胆结石相关的疼痛。常见的诱发性食物包括：高脂肪食物（如油炸食品、肥肉）、高糖食品（如甜点、含糖饮料）、辛辣食物、碳酸饮料、含咖啡因饮品（如咖啡、浓茶）。建议胆结石患者尽量避免上述食物，以减轻胆囊负担，降低疼痛发作的风险。
- Small regular meals instead of large meals
提倡少量多餐
Regular meals stimulate gallbladder emptying. Meanwhile, prolonged fasting can reduce gallbladder emptying, subsequently increasing the risk of gallstone formation. Therefore, consumption of smaller meals throughout the day instead of one to two large meals per day can help in reducing the risk of gallstone.
规律进食有助于促进胆囊规律排空，减少胆汁滞留。而长时间禁食或进食不规律可能导致胆囊排空功能下降，使胆汁浓缩、胆固醇沉积，进而增加胆结石形成的风险。因此，相较于每天仅进食一至两顿大餐，采取少量多餐的饮食方式更有助于维持胆囊的正常功能，降低胆结石的发生几率。
- Safe weight management
安全的体重管理
Overweight and obesity significantly elevate the risk of gallstone production. This is as being overweight increases cholesterol production by the liver, which is then accumulated in the bile, causing an increase in bile concentration. Being overweight also cause insulin resistance, which can further raise the production of cholesterol in the liver. Furthermore, excess body weight can lead to gallbladder stasis and inefficient gallbladder emptying, leading to gallstone formation. Therefore, weight reduction through healthy eating and physical activity should be practiced.
However, avoid rapid weight loss. This is as rapid weight loss of more than 1.5 kg per week can contribute to the risk of gallstones formation. This is as low energy due to excess dieting and rapid weight loss may increase saturation of bile and reduce gallbladder emptying.
超重与肥胖会显著提高胆结石的发生风险。这是因为体内脂肪过多会促使肝脏分泌更多胆固醇，过量的胆固醇积存在胆汁中，使其浓度升高，形成结石的可能性随之增加。同时，体重过重还可能引发胰岛素抵抗，进一步加剧胆固醇合成。此外，脂肪堆积还会导致胆囊排空变慢，使胆汁长时间滞留，最终促成胆结石的形成。因此，保持健康体重是预防胆结石的重要一步。建议通过均衡饮食、适度运动、逐步、稳定地减重，帮助身体恢复良好代谢状态，保护胆囊功能。
但是特别提醒：切忌快速减重。每周建忠超过1.5公斤，看似效果显著，实则可能适得其反。快速减重常因低热量摄入导致胆汁中胆固醇过饱和，胆囊活动减弱，反而加剧胆结石的风险。
- Reduce saturated and trans-fat intake
减少饱和脂肪与反式脂肪
High saturated and trans-fat intake can increase the risk of gallbladder stone, as these fats can cause an elevation in cholesterol level in bile and disrupt the bile motility. Meanwhile, polyunsaturated fats can inhibit cholesterol gallstones through decreasing bile cholesterol saturation. Very low-fat diet is not suggested as to stimulate bile secretion by the gallbladder, healthy fat intake is needed. Very low-fat intake prevents this process, and may lead to reduced gallbladder emptying, causing increased risk of gallstones formation. Aside that, fat is also needed for other body functions including vitamin absorption, insulator, walls of cells formation, organ protection et cetera.
摄入过多的饱和脂肪和反式脂肪会增加胆结石的风险，因为这类脂肪会提升胆汁中的胆固醇含量，并干扰胆汁的正常流动与排空。而多不饱和脂肪则通过降低胆汁中胆固醇的饱和度，来抑制胆固醇结石的形成。此外，极低脂肪饮食并不建议采用。为了刺激胆囊正常分泌胆汁，身体需要一定量的健康脂肪。摄入脂肪过低会抑制但是分泌和胆囊排空，从而增加胆结石的风险。脂肪还对身体具有多种重要功能，包括帮助脂溶性维生素的吸收、维持体温、构建细胞膜及保护内脏器官等，因此适量摄入脂肪对维持整体健康至关重要。
- Reduce added sugars and refined carbohydrates intake
减少添加糖和精制碳水化合物
High intake of added sugars and refined carbohydrates can lead to gallstone formation as it can cause insulin resistance. Insulin resistance can cause increase in cholesterol secretion, hence higher concentration of bile cholesterol. Furthermore, insulin resistance can cause downregulation of an enzyme responsible for bile acid synthesis which is protective against gallstone formation and can cause dysmotility of the gallbladder.
摄入过多的添加糖和精制碳水化合物可能增加胆结石形成的风险。这是因为高唐高精制碳水的食物容易引发胰岛素抵抗，进而导致胆固醇分泌增多，使胆汁中的胆固醇含量升高，促进胆结石的生成。同时，胰岛素抵抗还会抑制一种关键酶的活性，该酶负责胆汁酸的合成，而胆汁酸对防止胆结石具有保护作用。此外，胰岛素抵抗还可能引起胆囊动力异常，影响胆汁的正常排出，进一步增加胆结石的风险。
- Increase fibre intake
增加膳食纤维
Gut bacteria can produce secondary bile acids, which can be absorbed by the body and can lead to increase biliary cholesterol saturation. Fibre speeds up the movement of food in the intestine. This in turn may decrease the bacterial production of secondary bile acids, leading to reduced absorption and buildup of bile acids. Fibre also aids in weight management and in improving insulin sensitivity, further reducing the risk of gallstones.
肠道菌群能够产生次级胆汁酸，这些次级胆汁酸被人体吸收后，可能导致胆汁中胆固醇的饱和度升高。膳食纤维能够加快食物在肠道内的通过速度，从而减少肠道细菌产生次级胆汁酸的机会，降低胆汁酸的吸收和堆积。除此之外，膳食纤维还有助于控制体重和改善胰岛素敏感性，进而降低胆结石的发生风险。
All in all, adopting healthy dietary and lifestyle practices can significantly reduce the risk of gallstone formation.
综合上述，养成健康的饮食习惯和生活方式能够有效降低胆结石的发生风险。
资料来源：NHS UK 2021, 2023, 2024, 2025; Tehrani A. N. et al 2023; Ratheesh R. et al 2023; PCRM US 2022; Ciaula A. D. et al 2019, 2021; Cortés V. A. et al 2019; Zhu Q. et al 2016; Figurski A. C. 2012; Nakeeb A. et al 2006; Dept of Health Au n.d.
