Formation of Gallstones

Formation of Gallstones 

Gallstones usually form in the gall bladder, but they can also from wherever there is bile, e.g. in the ducts that carry bile. Bile consists of cholesterol, bilirubin, and bile salts dissolved in water. Bilirubin and cholesterol are present in the bile as waste materials that are being eliminated from the body. Most gallstones form when there is too much cholesterol in the bile. Cholesterol drops out of the liquid part of the bile, just like excess sugar or salt form crystals at the bottom of a glass of water. The tiny crystals of cholesterol group together to form large masses called gallstones. Cholesterol stones can also form when the gall bladder does not empty normally, and the bile is stored for long periods of time. 
Some gallstones are formed from bilirubin. They are called 'pigment stones'. Pigment gallstones are the second most common type of gallstones. 

Gallstones can also form in patients taking the antibiotic ceftriaxone. Ceftriaxone is eliminated from the body through the bile in high concentrations. Most of these gallstones disappear once the antibiotic is discontinued. 

Patients can also have 'mixed' stones, mixtures of cholesterol, bilirubin, calcium, and other material. Gallstones may be as small as a grain of sand or as large as a walnut. There can be a single stone or multiple stones. The medical name for gallstones is cholelithiasis. 

Causes and Risk Factors 

Several factors increase the risk for gall bladder stone : 

1. Gender : Women between the ages of 20 and 40 are twice as likely to get gallstones as compared to men. Oestrogen ( the female sex hormone ) increases the amount of cholesterol in the bile. Extra oestrogen from birth control pills or hormone replacement therapy may further increase bile's cholesterol content. It also may slow gall bladder emptying, allowing bile to stand for longer periods of time. 

2. Pregnancy : Pregnancy increases the risk for cholesterol gall stones because the bile contains more cholesterol during pregnancy, and the gall bladder does not contract normally. 

3. Birth Control pills and hormone therapy: These treatments increase the levels of oestrogen. The effect of oestrogen has been discussed above. 

4. Obesity : Being overweight tends to reduce the amount of bile salts. Obesity also slows the rate at which the gall bladder empties. Even being moderately overweight can increase the risk of gallstones. 

5. Rapid weight loss : Rapid weight loss by whatever means causes cholesterol gallstone formation in up to 50 per cent of individuals. 'Crash diets' and fasting make the body burn, or metabolise, fat very rapidly. The liver reacts by releasing extra cholesterol into the bile. 

6. Age : Although gallstones can occur in younger people, especially women, most cases are diagnosed in people over the age of 40.

7. Increased blood triglycerides : Gallstones occur more frequently in individuals with elevated blood triglyceride levels. 

8. Taking cholesterol - lowering drugs : Certain drugs that lower blood cholesterol may increase the amount of cholesterol passed out of the body into the bile. 

Gallstones
Formation of Gallstones
Symptoms of Gallstones
Diagnosis for Gallstones
Treatment for Gallstones
Medications for Gallstones