What is Gallbladder stone disease?
Gallstone disease refers to the condition where gallstones are either in the gallbladder or common bile duct. The presence of stones in the gallbladder is referred to as cholelithiasis. Gallbladder stone disease is the most common gastrointestinal disorder requiring hospitalization, and approximately 800,000 cholecystectomies are annually performed in the United States of America.
Symptoms of Gallbladder stone disease
Most patients with gallbladder stone disease are asymptomatic; however, gallbladder stone disease can cause biliary pain, cholecystitis, cholangitis, pancreatitis, gallbladder cancer, and even gallstone ileus.
Risk factors in Gallbladder Stone disease
The risk factors associated with gallbladder stone disease include female sex, aging, obesity, hyperlipidemia, diabetes, and alcohol consumption.
It has been well recognized that gallbladder stone disease is closely associated with cardiovascular disease due to shared risk factors in common, such as metabolic disorders, and shared pathogenesis, such as cholesterol deposition for the gallstone formation and atherosclerotic plaque formation.
Similarly, erectile dysfunction has been regarded as a marker for the severity of cardiovascular disease since they share common pathophysiological mechanisms of atherosclerosis and endothelial dysfunction for the penile artery and the coronary artery. Moreover, psychological stress is associated with gallbladder stone disease due to liability to bile stasis and impaired gallbladder emptying. Similarly, psychological stress is associated with the development of organic and psychogenic erectile dysfunction.
The association of gallbladder stone disease with erectile dysfunction
Gallbladder stone disease is mostly observed in men aged over 65 years and it is mostly associated with aging. The higher prevalence of gallbladder stone disease in the older men population may be a consequence of increased intestinal absorption of cholesterol, enhanced biliary secretion of cholesterol, decreased synthesis and secretion of bile salts, and impaired gallbladder emptying in the aging process.
Hypertension, Hyperlipidemia, and Diabetes were the most common problems in order of frequency for men with gallbladder stone disease. The association between hypertension and gallbladder stone disease remains unknown; however, an increased sympathetic tone with impaired gastrointestinal motility is suggested to be a risk factor common for gallbladder stone disease in hypertensive patients. Moreover, diabetes can contribute to gallbladder stone disease development because insulin resistance increases cholesterol secretion into bile, and hyperglycemia can impair gallbladder emptying.
The association of gallbladder stone disease with erectile dysfunction may be due to the following common pathophysiological mechanisms.
- The saturation of cholesterol into bile for enhancing the development of gallbladder stone disease is similar to the pathogenesis of atherosclerotic plaque deposition in the penile arteries of organic erectile dysfunction.
- Patients with gallbladder stone disease have low plasma levels of insulin, which impairs postprandial gallbladder emptying. Similarly, the antiatherosclerotic effect of insulin diminishes in patients with gallbladder stone disease with low plasma insulin.
- Gallbladder stone disease is characterized by an increased degree of inflammation and oxidative stress. Similarly, increased oxidative stress increases the susceptibility to atherosclerosis in penile arteries of men with organic erectile dysfunction.
- The bidirectional association has been established between gallbladder stone disease and psychosocial stress. Patients with gallbladder stone disease tend to be more obsessive, and autonomic nervous dysfunction with impaired gallbladder emptying was more prevalent in these patients. A bidirectional association has also been recognized between erectile dysfunction and psychosocial stress.
- Men with erectile dysfunction exhibit a higher risk of psychosocial stress than those without erectile dysfunction and smooth muscle dysfunction beyond endothelial dysfunction supposedly develops before the onset of systemic vascular diseases. Our findings strongly support the association between psychosocial stress and organic erectile dysfunction.
Gallbladder stone disease and Erectile Dysfunction share the common risks and it is mostly in men aged over 65. Gallbladder stone disease is also associated with an increased risk of organic erectile dysfunction, but it has no association with psychogenic erectile dysfunction.
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