Gallstone disease causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Causes

Gall bladder opened to show numerous **gallstones**. Their brownish to greenish color suggest they are cholesterol calculi.

Progress has been made in understanding the process of gallstone formation. Researchers believe that gallstones may be caused by a combination of factors, including inherited body chemistry, body weight, gallbladder motility (movement), and perhaps diet. Additionally, people with erythropoietic protoporphyria (EPP) are at increased risk to develop gallstones.^[1]

Cholesterol gallstones develop when bile contains too much cholesterol and not enough bile salts. Besides a high concentration of cholesterol, two other factors seem to be important in causing gallstones. The first is how often and how well the gallbladder contracts; incomplete and infrequent emptying of the gallbladder may cause the bile to become overconcentrated and contribute to gallstone formation. The second factor is the presence of proteins in the liver and bile that either promote or inhibit cholesterol crystallization into gallstones.

In addition, increased levels of the hormone estrogen as a result of pregnancy, hormone therapy, or the use of combined (estrogen-containing) forms of hormonal contraception, may increase cholesterol levels in bile and also decrease gallbladder movement, resulting in gallstone formation.

No clear relationship has been proven between diet and gallstone formation. However, low-fiber, high-cholesterol diets, and diets high in starchy foods have been suggested as contributing to gallstone formation. Other nutritional factors that may increase risk of gallstones include rapid weight loss, constipation, eating fewer meals per day, eating less fish, and low intakes of the nutrients folate, magnesium, calcium, and vitamin C.^[2] On the other hand, wine and whole grain bread may decrease the risk of gallstones.^[3]

Common Causes

Causes by Organ System

Cardiovascular	Williams syndrome
Chemical / poisoning	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	Ceftriaxone, Clofibrate, Combined oral contraceptive pill, Hormonal contraception, Lanreotide, Pasireotide, Proton pump inhibitors, Somatostatin
Ear Nose Throat	No underlying causes
Endocrine	Diabetes, Somatostatinoma
Environmental	No underlying causes
Gastroenterologic	Crohn's disease, Liver cirrhosis, Ulcerative colitis, Cystic fibrosis
Genetic	Erythropoietic protoporphyria, Hemochromatosis, Hereditary spherocytosis, Williams Syndrome , Hemoglobin E disease, Hemolytic anemia, Sickle cell disease, Cystic fibrosis
Hematologic	Hemoglobin E disease, Hemolytic anemia, Sickle cell disease, Hemochromatosis, Hereditary spherocytosis, Erythropoietic protoporphyria
Iatrogenic	Long term intravenous nutrition, Weight loss surgery
Infectious Disease	Clonorchiasis, Infection in the gallbladder
Musculoskeletal / Ortho	No underlying causes
Neurologic	Williams syndrome
Nutritional / Metabolic	Hypercalcaemia, Low-fibre, high-cholesterol diets, Hemochromatosis, Williams syndrome, Erythropoietic protoporphyria, Dieting, Fasting
Obstetric/Gynecologic	Pregnancy
Oncologic	Somatostatinoma
Opthalmologic	No underlying causes
Overdose / Toxicity	Ceftriaxone, Clofibrate, Combined oral contraceptive pill, Hormonal contraception, Lanreotide, Pasireotide, Proton pump inhibitors, Somatostatin
Psychiatric	No underlying causes
Pulmonary	Cystic fibrosis
Renal / Electrolyte	No underlying causes
Rheum / Immune / Allergy	Ulcerative colitis, Crohn's disease
Sexual	Cystic fibrosis
Trauma	No underlying causes
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	Aging, Dieting, Fasting, Obesity, Rapid weight loss

Causes in Alphabetical Order

References

↑ "Erythropoietic Protoporphyria". Merck Manual. Retrieved 2007-08-25.
↑ R.M. Ortega (1997). "Differences in diet and food habits between patients with gallstones and controls". Journal of the American College of Nutrition. 16: 88–95. Unknown parameter |month= ignored (help); Unknown parameter |coauthors= ignored (help); |access-date= requires |url= (help)
↑ European Journal Gastroenterology & Hepatology. 6: 585–593. 1995. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)

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[1] "Erythropoietic Protoporphyria". Merck Manual. Retrieved 2007-08-25.

[2] R.M. Ortega (1997). "Differences in diet and food habits between patients with gallstones and controls". Journal of the American College of Nutrition. 16: 88–95. Unknown parameter |month= ignored (help); Unknown parameter |coauthors= ignored (help); |access-date= requires |url= (help)

[3] European Journal Gastroenterology & Hepatology. 6: 585–593. 1995. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)

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