Who is at risk for gallstones-

Risk for cholesterol gallstones.

There is no relationship betweencholesterol in the blood and cholesterol gallstones. Individuals with elevatedblood cholesterol do not have an increased prevalence of cholesterolgallstones. A common misconception is that diet is responsible for thedevelopment of cholesterol gallstones, however, it isn't. The risk factors fordeveloping cholesterol gallstones include:四川省第四人民医院消化内科常玉英

Gender. Gallstones occur more commonly inwomen than men.

Age. Gallstone prevalence increases withage.

Obesity. Obese individuals are more likelyto form gallstones than thin individuals.

Pregnancy. Pregnancy increases the risk forcholesterol gallstones because during pregnancy, bile contains morecholesterol, and the gallbladder does not contract normally.

Birth control pills and hormone therapy Theincreased levels of hormones caused by either treatment mimics pregnancy.

Rapid weight loss. Rapid weight loss bywhatever means, very low calorie diets or obesity surgery, causes cholesterolgallstones in up to 50% of individuals. Many of the gallstones will disappearafter the weight is lost, but many do not. Moreover, until they are gone, theymay cause problems.

Crohn's disease. Individuals with Crohn'sdisease of the terminal ileum are more likely to develop gallstones. Gallstonesform because patients with Crohn's disease lack enough bile acids to solubilizethe cholesterol in bile. Normally, bile acids that enter the small intestinefrom the liver and gallbladder are absorbed back into the body in the terminalileum and are secreted again by the liver into bile. In other words, the bileacids recycle. In Crohn's disease, the terminal ileum is diseased. Bile acidsare not absorbed normally, the body becomes depleted of bile acids, and lessbile acids are secreted in bile. As a result there is not enough bile acids tokeep cholesterol dissolved in bile, resulting in gallstone formation.

Increased blood triglycerides. Gallstonesoccur more frequently in individuals with elevated blood triglyceride levels.

Risk for pigment gallstones

Black pigment gallstones form whenever anincreased load of bilirubin reaches the liver. This occurs when there isincreased destruction of red blood cells, as in diseases such as sickle celldisease and thalassemia. Black pigment gallstones also are more common inpatients with cirrhosis of the liver. Brown pigment gallstones form when thereis stasis of bile (decreased flow), for example, when there are narrow orobstructed bile ducts.