Causes of Gallstones
List of causes of Gallstones
Following is a list of causes or underlying conditions
(see also Misdiagnosis of underlying causes of Gallstones)
that could possibly cause Gallstones includes:
More causes:
see full list of causes for Gallstones
Causes of Gallstones (Diseases Database):
The follow list shows some of the possible medical causes of Gallstones
that are listed by the Diseases Database:
Source: Diseases Database
Gallstones Causes: Book Excerpts
Gallstones as a complication of other conditions:
Other conditions that might have
Gallstones as a complication may,
potentially, be an underlying cause of Gallstones.
Our database lists the following as having
Gallstones as a complication of that condition:
Gallstones as a symptom:
Conditions listing Gallstones
as a symptom may also be potential underlying causes of Gallstones.
Our database lists the following as having
Gallstones as a symptom of that condition:
Medications or substances causing Gallstones:
The following drugs, medications, substances or toxins are some of the possible
causes of Gallstones as a symptom.
This list is incomplete and various other drugs or substances
may cause your symptoms.
Always advise your doctor of any medications or treatments you are using,
including prescription, over-the-counter, supplements, herbal or alternative treatments.
See full list of 21
medications causing Gallstones
What causes Gallstones?
Article excerpts about the
causes of Gallstones:
Gallstones: NIDDK (Excerpt)
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.
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 one's 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 rates 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.
(Source: excerpt from
Gallstones: NIDDK)
Dieting and Gallstones: NIDDK (Excerpt)
Most
researchers believe three conditions are necessary to form gallstones.
First, the bile becomes supersaturated with cholesterol, which means the
bile contains more cholesterol than the bile salts can dissolve. Second,
an imbalance of proteins or other substances in the bile causes the
cholesterol to start to crystallize. Third, the gallbladder does not
contract enough to empty its bile regularly.
(Source: excerpt from Dieting and Gallstones: NIDDK)
Medical news summaries relating to Gallstones:
The following medical news items are relevant to causes of Gallstones:
Related information on causes of Gallstones:
As with all medical conditions,
there may be many causal factors.
Further relevant information on causes of Gallstones may be found in:
Causes of Gallstones: Online Medical Books
16 MEDICAL BOOKS ONLINE!
Review excerpts from medical books online, free, without registration,
for more information about the causes of Gallstones.
Calcium imbalance:
Causes
(Professional Guide to Diseases (Eighth Edition))
Common causes of hypocalcemia include:
❑ inadequate intake of calcium and vitamin D, in which inadequate levels of vitamin D inhibit intestinal absorption of calcium
❑ hypoparathyroidism as a result of injury, disease, or surgery that decreases or eliminates secretion of parathyroid hormone (PTH), which is necessary for calcium absorption and normal serum calcium levels
❑ malabsorption or loss of calcium from the GI tract, caused by increased intestinal motility from severe diarrhea or laxative abuse; can also result from inadequate levels of vitamin D or PTH, or a reduction in gastric acidity, decreasing the solubility of calcium salts
❑ severe infections or burns, in which diseased and burned tissue traps calcium from the extracellular fluid
❑ overcorrection of acidosis, resulting in alkalosis, which causes decreased ionized calcium and induces symptoms of hypocalcemia
❑ pancreatic insufficiency, which may cause malabsorption of calcium and subsequent calcium loss in feces. In pancreatitis, participation of calcium ions in saponification contributes to calcium loss
❑ renal failure, resulting in excessive excretion of calcium secondary to increased retention of phosphate
❑ hypomagnesemia, which causes decreased PTH secretion and blocks the peripheral action of that hormone.
Causes of hypercalcemia include the following:
❑ hyperparathyroidism, which increases serum calcium levels by promoting calcium absorption from the intestine, resorption from bone, and reabsorption from the kidneys
❑ hypervitaminosis D, which can promote increased absorption of calcium from the intestine
❑ tumors, which raise serum calcium levels by destroying bone or by releasing PTH or a PTH-like substance, osteoclast-activating factor, prostaglandins and, perhaps, a vitamin D-like sterol
❑ multiple fractures and prolonged immobilization, which release bone calcium and raise the serum calcium level
❑ multiple myeloma, which promotes loss of calcium from bone.
Other causes include milk-alkali syndrome, sarcoidosis, hyperthyroidism, adrenal insufficiency, thiazide diuretics, and loss of serum albumin secondary to renal disease.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Cholelithiasis and related disorders:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
Cholelithiasis, stones or calculi (gallstones) in the gallbladder, results from changes in bile components. Gallstones are made of cholesterol, calcium bilirubinate, or a mixture of cholesterol and bilirubin pigment. They arise during periods of sluggishness in the gallbladder due to pregnancy, hormonal contraceptives, diabetes mellitus, celiac disease, cirrhosis of the liver, and pancreatitis. Cholelithiasis is a common health problem, affecting about 1 out of every 1,000 people. The prognosis is usually good with treatment unless infection occurs, in which case the prognosis depends on its severity and response to antibiotics.
One out of every 10 patients with gallstones develops choledocholithiasis, or gallstones in the common bile duct (sometimes called “common duct stones”). This occurs when stones passed out of the gallbladder lodge in the hepatic and common bile ducts and obstruct the flow of bile into the duodenum. Prognosis is good unless infection occurs.
Cholangitis, infection of the bile duct, is commonly associated with choledocholithiasis and may follow percutaneous transhepatic cholangiography or occlusion of endoscopic stents. Predisposing factors may include bacterial or metabolic alteration of bile acids. Widespread inflammation may cause fibrosis and stenosis of the common bile duct. The prognosis for this rare condition is poor without stenting or surgery.
Cholecystitis, acute or chronic inflammation of the gallbladder, is usually associated with a gallstone impacted in the cystic duct, causing painful distention of the gallbladder. Cholecystitis accounts for 10% to 25% of all patients requiring gallbladder surgery. The acute form is most common during middle age; the chronic form usually occurs among elderly patients. The prognosis is good with treatment.
Cholesterolosis, polyps or crystal deposits of cholesterol in the gallbladder’s submucosa, may result from bile secretions containing high concentrations of cholesterol and insufficient bile salts. The polyps may be localized or speckle the entire gallbladder. Cholesterolosis, the most common pseudotumor, isn’t related to widespread inflammation of the mucosa or lining of the gallbladder. The prognosis is good with surgery.
Biliary cirrhosis, ascending infection of the biliary system, sometimes follows viral destruction of liver and duct cells, but the primary cause is unknown. This condition usually leads to obstructive jaundice and involves the portal and periportal spaces of the liver. It’s nine times more common among women ages 40 to 60 than among men. The prognosis is poor without liver transplantation.
Gallstone ileus results from a gallstone lodging at the terminal ileum; it’s more common in the elderly. The prognosis is good with surgery.
Postcholecystectomy syndrome commonly results from residual gallstones or stricture of the common bile duct. It occurs in 1% to 5% of all patients whose gallbladders have been surgically removed and may produce right upper quadrant abdominal pain, biliary colic, fatty food intolerance, dyspepsia, and indigestion. The prognosis is good with selected radiologic procedures, endoscopic procedures, or surgery.
Acalculous cholecystitis is more common in critically ill patients, accounting for about 5% of cholecystitis cases. It may result from primary infection with such organisms as Salmonella typhi, Escherichia coli, or Clostridium or from obstruction of the cystic duct due to lymphadenopathy or a tumor. It appears that ischemia, usually related to a low cardiac output, also has a role in the pathophysiology of this disease. Signs and symptoms of acalculous cholecystitis include unexplained sepsis, right upper quadrant pain, fever, leukocytosis, and a palpable gallbladder.
Each of these disorders produces its own set of complications. Cholelithiasis may lead to any of the disorders associated with gallstone formation: cholangitis, cholecystitis, choledocholithiasis, and gallstone ileus. Cholecystitis can progress to gallbladder complications, such as empyema, hydrops or mucocele, or gangrene. Gangrene may lead to perforation, resulting in peritonitis, fistula formation, pancreatitis, limy bile, and porcelain gallbladder. Other complications include chronic cholecystitis and cholangitis.
Choledocholithiasis may lead to cholangitis, obstructive jaundice, pancreatitis, and secondary biliary cirrhosis. Cholangitis, especially in the suppurative form, may progress to septic shock and death. Gallstone ileus may cause bowel obstruction, which can lead to intestinal perforation, peritonitis, septicemia, secondary infection, and septic shock.
In most cases, gallbladder and bile duct diseases occur in people who are older than age 40 and are more prevalent in women and Native Americans.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Calcium imbalance:
Causes
(Handbook of Diseases)
Several factors can cause calcium imbalance.
Hypocalcemia
❑ Inadequate intake of calcium and vitamin D results in inhibited intestinal absorption of calcium.
❑ Hypoparathyroidism as a result of injury, disease, or surgery decreases or eliminates secretion of parathyroid hormone (PTH), which is necessary for calcium absorption and normal serum calcium levels.
❑ Malabsorption or loss of calcium from the GI tract can result from increased intestinal motility from severe diarrhea or laxative abuse. Malabsorption of calcium from the GI tract can also result from inadequate levels of vitamin D or PTH or a reduction in gastric acidity, which decreases the solubility of calcium salts.
❑ Severe infections or burns can lead to diseased and burned tissue trapping calcium from the extracellular fluid.
❑ Overcorrection of acidosis can lead to alkalosis, which causes decreased ionized calcium and induces symptoms of hypocalcemia.
❑ Pancreatic insufficiency may cause malabsorption of calcium and subsequent calcium loss in stool. In pancreatitis, participation of calcium ions in saponification contributes to calcium loss.
❑ Renal failure results in excessive excretion of calcium secondary to increased phosphate retention. Renal failure also results in loss of the active metabolite of vitamin D, which impairs calcium absorption.
❑ Hypomagnesemia causes decreased PTH secretion and blocks the peripheral action of that hormone.
Hypercalcemia
❑ Hyperparathyroidism increases serum calcium levels by promoting calcium absorption from the intestine, resorption from bone, and reabsorption from the kidneys.
❑ Hypervitaminosis D can promote increased absorption of calcium from the intestine.
❑ Tumors raise serum calcium levels by destroying bone or by releasing PTH or a PTH-like substance, osteoclast-activating factor, prostaglandins and, perhaps, a vitamin D–like sterol.
❑ Multiple fractures and prolonged immobilization release bone calcium and raise the serum calcium level.
❑ Multiple myeloma promotes loss of calcium from bone.
Other causes include milk-alkali syndrome, sarcoidosis, hyperthyroidism, adrenal insufficiency, and thiazide diuretics.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Cholelithiasis, cholecystitis, and related disorders:
Causes
(Handbook of Diseases)
The origin and frequency of gallbladder and biliary tract disease vary with the particular disorder.
Cholelithiasis
The presence of stones or calculi (gallstones) in the gallbladder results from changes in bile components. Gallstones are made of cholesterol, calcium bilirubinate, or a mixture of cholesterol and bilirubin pigment. They arise during periods of sluggishness in the gallbladder resulting from pregnancy, use of oral contraceptives, diabetes mellitus, Crohn’s disease, cirrhosis of the liver, pancreatitis, obesity, and rapid weight loss.
Cholelithiasis is the fifth leading cause of hospitalization among adults and accounts for 90% of all gallbladder and duct diseases. The prognosis is usually good with treatment unless infection occurs, in which case the prognosis depends on the infection’s severity and response to antibiotics.
Cholecystitis
Cholecystitis, an acute or chronic inflammation of the gallbladder, is usually associated with a gallstone impacted in the cystic duct; the inflammation develops behind the obstruction. Cholecystitis accounts for 10% to 25% of all patients requiring gallbladder surgery.
The acute form is most common during middle age; the chronic form, among elderly people. The prognosis is good with treatment.
Biliary cirrhosis
Primary biliary cirrhosis is a chronic, progressive disease of the liver characterized by autoimmune destruction of the intrahepatic bile ducts and cholestasis. This condition usually leads to obstructive jaundice and pruritus and involves the portal and periportal spaces of the liver. It affects women between the ages of 40 and 60 nine times more often than men. The prognosis is poor without liver transplantation.
Cholangitis
An infection of the bile duct, cholangitis is commonly associated with choledocholithiasis and may follow percutaneous transhepatic cholangiography. Predisposing factors include bacterial or metabolic alteration of bile acids. Widespread inflammation may cause fibrosis and stenosis of the common bile duct. The prognosis for this rare condition is poor without stenting or surgery.
Choledocholithiasis
One out of every 10 patients with gallstones develops choledocholithiasis, or gallstones in the common bile duct (sometimes called common duct stones). This occurs when stones passed out of the gallbladder lodge in the hepatic and common bile ducts and obstruct the flow of bile into the duodenum. The prognosis is good unless infection occurs.
Cholesterolosis
Cholesterol polyps or cholesterol crystal deposits in the gallbladder’s submucosa may result from bile secretions containing high concentrations of cholesterol and insufficient bile salts. The polyps may be localized or may speckle the entire gallbladder. Cholesterolosis, the most common pseudotumor, isn’t related to widespread inflammation of the mucosa or lining of the gallbladder. The prognosis is good with surgery.
Gallstone ileus
Gallstone ileus results from a gallstone lodging in the terminal ileum. It’s more common in elderly people. The prognosis is good with surgery.
Postcholecystectomy syndrome
Postcholecystectomy syndrome commonly results from retained or recurrent common bile duct stones, spasm of the sphincter of Oddi, functional bowel disorder, technical errors, or mistaken diagnoses. It occurs in 1% to 5% of all patients whose gallbladders have been surgically removed and may produce right upper quadrant abdominal pain, biliary colic, fatty food intolerance, dyspepsia, and indigestion. The prognosis is good with selected radiologic procedures, endoscopic procedures, or surgery.
Complications
Each disorder produces its own set of complications. Cholelithiasis may lead to any of the disorders associated with gallstone formation: cholangitis, cholecystitis, choledocholithiasis, or gallstone ileus.
Cholecystitis can progress to gallbladder complications, such as empyema, hydrops or mucocele, or gangrene. Gangrene may lead to perforation, resulting in peritonitis, fistula formation, pancreatitis, limy bile, and porcelain gallbladder. Other complications include chronic cholecystitis and cholangitis.
Choledocholithiasis may lead to cholangitis, obstructive jaundice, pancreatitis, and secondary biliary cirrhosis. Cholangitis, especially in the suppurative form, may progress to septic shock and death. Gallstone ileus may cause bowel obstruction, which can lead to intestinal perforation, peritonitis, septicemia, secondary infection, and septic shock.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Cholelithiasis:
Cholelithiasis - risk factors
(The 5-Minute Pediatric Consult)
- Chronic overnutrition with carbohydrate and triglyceride-rich, low-fiber diet
- Obesity
- Positive family history
- Native American descent
- Female gender
- Pregnancy/Parity
- Chronic hemolysis (sickle cell disease, thalassemia, spherocytosis, malaria).
- Ineffective erythropoiesis (vitamin B12 and folate deficiencies)
- Liver cirrhosis
- TPN
- Severe Crohn disease of the ileum and/or ileal resection
- Anatomical abnormalities (biliary stricture, duodenal diverticulum)
- Medications (estrogens, octreotide, clofibrate, furosemide, cyclosporine, ceftriaxone)
» READ BOOK EXCERPT ONLINE »
Source: The 5-Minute Pediatric Consult, 2008
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