Gallstones

Gallstone disease occurs when hard fatty or mineral deposits ( gallstones ) form in the gall bladder

Epidemiology-Very common - 5-30 % of adults in W EuropeUK around 10-15 % Most people are asymptomatic ( ~ 90 % unaware carriers )Majority of gallstones are cholesterol - main component Substantial economic burden to health-care systems globally Most common GI disease that requires hospitalization

Cause -Gallstone formation is multifactorial including a complex interplay pf sex-specific , genetic, lifestyle and co-morbidity associated factors Cholesterol stones- alteration in the balance between pronucleating factors and antinucleating factors in the bile Factors contributing include increased bile cholesterol saturation , impaired gallbladder motor function, changes in enterohepatic circulation Haemolysis / Chronic bacterial or parasitic infestations can lead to pigment stones ( preventable )

Risk factors - Increasing age Female sex Pregnancy High dose oestrogen treatmenteg use of COCP, HRT Ethnicity Genetic traits Obesity Crohns disease Testosterone Rx in Smoking, alcohol Acromegalic patients undergoing Rx with somatostatinanalogues. High serum triglyceride levels Low HDL Rapid weight loss High calorific diet Refined carbohydrate diet Lack of physical activity Cirrhosis Gallbladder stasis Haemolysis Chronic bacterial or parasitic infection Type 2 diabetes ( x2 ↑ common ) Loss of bile salts- eg...