NEW JERSEY — A Rutgers Health researcher is urging the public to take recurring “heartburn,” chest pain and nausea more seriously this holiday season, warning that these symptoms are often misdiagnosed and may instead indicate gallstone disease — a condition that frequently leads to emergency surgery.
A new Rutgers Health study published in the Journal of Surgical Research found that patients who know their family’s surgical history are far more likely to recognize gallstone symptoms early and avoid dangerous, emergency gallbladder removal.
People often dismiss gallstone symptoms as stress, food poisoning, or indigestion, said Gregory Peck, an associate professor in the department of surgery at Rutgers Robert Wood Johnson Medical School and the study’s senior author. But the consequences of waiting too long can be severe.
“Gallstone disease is the most common abdominal digestive disease requiring emergency surgery,” Peck said. More than 1.2 million gallbladder removals — known as cholecystectomies — occur each year.
Peck noted that emergency gallbladder surgery carries significantly higher risks. “Emergency cholecystectomies have an estimated 60-times greater fatality rate compared to elective surgery,” he said. Patients in emergency cases face more inflammation, higher chances of bleeding or infection, longer hospital stays and, in extreme cases, bile duct injury requiring liver transplantation.
Symptoms often missed or mistaken
Gallstone symptoms can include pain in the upper abdomen or chest, pain that radiates to the back or shoulder, nausea, vomiting, fever, chills, indigestion, jaundice, loss of appetite and bloating. Patients in the study said symptoms frequently spiked at night.
Some even experienced symptoms after starting weight-loss medications such as GLP-1 receptor agonists.
Peck said many patients endured symptoms for “months and even years” before seeking care. Chest pain tied to gallstones may also be overlooked: of the 6.5 million annual ER visits for chest pain, up to half receive a diagnosis of “nonspecific chest pain,” even though many may actually have gallstone disease.
Family history plays a critical role
Researchers found a stark difference in awareness among patients.
Half of those who needed emergency surgery learned of their family history of gallbladder disease only after their diagnosis. In contrast, just 14% of patients who had elective surgery were unaware of their family history beforehand.
“Gallstone disease can be hereditary, especially in Hispanic populations,” Peck said. Genetic factors may account for 45% to 65% of risk.
Knowing family surgical history can help patients — and doctors — recognize symptoms sooner. “When people talk to their families about their medical history, they often ask about heart disease, cancer and stroke, but they rarely ask about the family’s surgical history,” Peck said. “People should ask what surgeries their parents, grandparents and other family members have had.”
Friends and family also played a key role in supporting patients once they received a diagnosis and needed surgery.
“Think: If you were able to take a pill that reduced your risk of emergency surgery of any kind, you would take it, right?” Peck said.
Rutgers researchers say that simply knowing your family’s surgical history might be the next best thing.
