Exercise and gall bladder function.

Epidemiological research has demonstrated protective effects of varying strength from physical activity against the risk for several chronic diseases such as coronary heart disease, hypertension, non-insulin-dependent diabetes mellitus and osteoporosis. Epidemiological studies have been supported by experimental research showing that exercise training improves coronary heart disease risk factors and other health-related factors. In contrast, the association between physical activity, exercise and gall stone disease has not yet been firmly established. This paper presents the theoretical role of aerobic exercise: (i) in the primary prevention of gall stone disease; and (ii) as a potential prokinetic agent in high risk gall stone disease groups. Primary risk factors in the pathogenesis of gall stone formation include cholesterol supersaturation in the solutes that precipitate from bile, hypernucleation (measured as "crystal appearance time') and finally hypomotility of the gall bladder which allows bile stasis and crystal formation. While the results of epidemiological studies suggest that physical activity may be inversely associated with gall stone disease, the mechanisms by which exercise may influence gall stone disease pathogeneses are poorly understood. In this paper the association between physical activity and exercise to gall bladder function and gall stone disease will be examined. Recommendations for future research and the implications for the primary prevention of gall stone disease will also be discussed.