Age and Sex Distribution of Biliary Colic (Gallstone Disease)
Gallstone disease predominantly affects women at approximately twice the rate of men, with prevalence increasing dramatically with age—reaching 35% in women and 20% in men by age 75. 1
Sex Distribution
Women are affected approximately twice as frequently as men across all age groups, with the overall incidence of gallstone disease being 18.8% in women compared to 9.5% in men in European populations 1
The female predominance is attributed to estrogen and progesterone exposure, which increases cholesterol secretion and decreases gallbladder motility 2
This sex difference persists throughout the lifespan, though the gap narrows somewhat in advanced age 1
Age Distribution
Age is a strong independent risk factor in both sexes, with prevalence increasing progressively throughout life 1, 2
At age 70 years: prevalence reaches 15% in males and 24% in females 1
At age 75 years: approximately 35% of women and 20% of men have developed gallstones 1, 3
At age 90 years: prevalence increases to 24% in males and 35% in females 1
In institutionalized elderly aged 90+ years: prevalence reaches 80% 1
Clinical Presentation Patterns
Biliary colic is the most common acute presentation of gallstone disease, occurring in 1-4% of patients with gallstones annually 1, 3
Approximately 80% of patients with gallstones remain asymptomatic throughout their lives 3, 2
Among symptomatic patients, only 10-20% experience severe pain requiring intervention 4, 5
Special Population Considerations
Primary biliary cholangitis (PBC) predominantly affects women and is typically diagnosed in the 5th and 6th decade, though up to 25% of cases are diagnosed at childbearing age 1
Primary sclerosing cholangitis (PSC) has a male-to-female ratio of approximately 2:1, with most women diagnosed at childbearing age 1
Pregnancy-related gallstone formation occurs in 3-8.1% of pregnant women, with gallstones detected in 12.2% of puerperal women compared to 1.3% of nulliparous controls 6, 7