Cholesterol Stones
Scientists believe cholesterol stones form
when bile contains too much cholesterol, too
much bilirubin, or not enough bile salts, or
when the gallbladder does not empty as it should
for some other reason.
Pigment Stones
The cause of pigment stones is uncertain.
They tend to develop in people who have
cirrhosis, biliary tract infections, and
hereditary blood disorders, such as sickle cell
anemia, in which too much bilirubin is formed.
Other Factors
It is believed that the mere presence of
gallstones may cause more gallstones to develop.
However, other factors that contribute to
gallstones have been identified, especially for
cholesterol stones.
- Obesity. Obesity is a major risk
factor for gallstones, especially in women.
A large clinical study showed that being
even moderately overweight increases the
risk for developing gallstones. The most
likely reason is that obesity tends to
reduce the amount of bile salts in bile,
resulting in more cholesterol. Obesity also
decreases gallbladder emptying.
- Estrogen. Excess estrogen from
pregnancy, hormone replacement therapy, or
birth control pills appears to increase
cholesterol levels in bile and decrease
gallbladder movement, both of which can lead
to gallstones.
- Ethnicity. Native Americans have
a genetic predisposition to secrete high
levels of cholesterol in bile. In fact, they
have the highest rate of gallstones in the
United States. A majority of Native American
men have gallstones by age 60. Among the
Pima Indians of Arizona, 70 percent of women
have gallstones by age 30. Mexican American
men and women of all ages also have high
rates of gallstones.
- Gender. Women between 20 and 60
years of age are twice as likely to develop
gallstones as men.
- Age. People over age 60 are more
likely to develop gallstones than younger
people.
- Cholesterol-lowering drugs. Drugs
that lower cholesterol levels in blood
actually increase the amount of cholesterol
secreted in bile. This in turn can increase
the risk of gallstones.
- Diabetes. People with diabetes
generally have high levels of fatty acids
called triglycerides. These fatty acids
increase the risk of gallstones.
- Rapid weight loss. As the body
metabolizes fat during rapid weight loss, it
causes the liver to secrete extra
cholesterol into bile, which can cause
gallstones.
- Fasting. Fasting decreases
gallbladder movement, causing the bile to
become overconcentrated with cholesterol,
which can lead to gallstones.
Who is at risk for
gallstones?
- women
- people over
age 60
- Native
Americans
- Mexican
Americans
- overweight
men and women
- people who
fast or lose a
lot of weight
quickly
- pregnant
women, women on
hormone
replacement
therapy, and
women who use
birth control
pills
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Article provided
by the National Digestive Diseases Information Clearinghouse
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