ROSH Gastrointestinal Practice Exam

Which factor is likely the most significant contributor to the development of gallbladder disease in a 45-year-old woman with a history of heavy smoking?

1. Alcohol consumption

2. Cigarette smoking

3. Family history

4. Marijuana smoking

The correct answer is: Cigarette smoking

Cigarette smoking is considered a significant risk factor for the development of gallbladder disease. In women, especially, studies have shown a correlation between smoking and the incidence of gallstones and related gallbladder conditions. The mechanisms by which smoking may influence gallbladder disease include alterations in bile composition and motility, as well as an increase in inflammatory processes. Other factors, while they can also contribute to gallbladder disease, are less directly linked compared to the influence of smoking. Family history can predispose individuals to gallbladder diseases, but its impact may not be as substantial as that of cigarette smoking, particularly in a patient with the individual's profile. Alcohol consumption can affect many aspects of health, but it does not have the same direct relationship with gallbladder disease as smoking does. Similarly, while marijuana smoking has its own health implications, there is not a significant body of evidence linking it directly to gallbladder disease in the same way as cigarette smoking. Overall, in the context provided, the history of heavy smoking aligns with the most established risk factor for gallbladder disease in this demographic group.