Spiti Valley Residents Face Gallstone Problem, Finds Study

Shimla: A large number of residents in the remote, high-altitude tribal Spiti Valley of Himachal Pradesh are reporting gallstones. This has been recorded in a recent study, titled Prevalence and Factors of Gallstone Disease in the High-Altitude Tribal Population of Spiti Valley, Northern India: A Population-Based Cross-Sectional Study, that has been published in the international medical journal Cureus. The study has found that more than one in five adults (21.3 per cent) in the Spiti Valley have gallstones, which is significantly higher than many other regions of the country.

The study was conducted in remote and high-altitude villages of the Spiti Valley where porters hauled machinery to testing sites in difficult terrain. The team of researchers visited Hikkim, Komik and other remote villages with ultrasound machines.

The study included on-site ultrasonography of 450 local residents between 30 and 70 years, while excluding patients with kidney stones who had already visited hospitals. Data was collected through random sampling.

The study was conducted between February 2024 and January 2026 by seven members under Dr Vipin Sharma, Assistant Professor of Surgery at Indira Gandhi Medical College in Shimla.

The sample population underwent fasting ultrasounds and were divided into three groups based on the altitude above sea level where they lived. The study found gallstone prevalence rates of 24 per cent in areas below 3,500 m, 24.7 per cent in the 3,501-4,000 m range, and 15.3 per cent in areas above 4,000 m. It is inferred from the data that the risk of disease does not automatically increase with altitude.

Overall, the study found that 21.3 per cent of people in the Spiti Valley had gallstones, which is significantly higher than previously reported cases in rural areas of the low-lying Gangetic plains of North India (approximately 4.15 per cent), and the high altitude Kashmir Valley (approximately 6.12 per cent).

Dr Vipin said, “High altitude alone is not a direct cause of this disease. Advancing age, hormonal changes in women and fatty liver are major risk factors. Multivariable logistic regression analysis found that the risk of gallstones increases by approximately 4 per cent with each year of age. Women were found to have a 2.04 times higher risk of this disease than men."

The expert said that fatty liver patients are at greater risk. He further stated that this problem is more prevalent in high altitude areas because the temperature there is below freezing point, because of which, physical activity decreases, and people drink less water. Consumption of dried meat in winter is also a major cause of gallstones, while people suffering from fatty liver are 1.79 times more likely to develop gallstones. The research also revealed that obesity, diabetes and high blood pressure did not have any independent or direct association with gallstones.

Dr Vipin explained that not getting gallstones treated promptly can lead to several serious health problems like gallbladder inflammation (acute cholecystitis), pancreatitis, obstructive jaundice and recurrent gallbladder pain. Furthermore, given the limited healthcare facilities in remote areas, the risk of developing complex diseases like gallbladder cancer may also increase in future.