Gallstone disease pathophysiology: Difference between revisions
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Researchers believe that gallstones may be caused by a combination of factors, including: | Researchers believe that gallstones may be caused by a combination of factors, including: | ||
*Inherited body chemistry | *Inherited body chemistry | ||
*Body weight | *[[Body weight]] | ||
*Gallbladder motility | *Gallbladder motility | ||
*Diet | *[[Diet (nutrition)|Diet]] | ||
*Erythropoietic protoporphyria<ref>{{cite web |url=http://www.merck.com/mmhe/sec12/ch160/ch160d.html |title=Erythropoietic Protoporphyria |accessdate=2007-08-25 |work=Merck Manual}}</ref> | *[[Erythropoietic protoporphyria]]<ref>{{cite web |url=http://www.merck.com/mmhe/sec12/ch160/ch160d.html |title=Erythropoietic Protoporphyria |accessdate=2007-08-25 |work=Merck Manual}}</ref> | ||
Cholesterol gallstones develop when bile contains too much cholesterol and not enough bile salts. | [[Cholesterol]] gallstones develop when bile contains too much cholesterol and not enough bile salts. | ||
The following factors also play a role: | The following factors also play a role: | ||
*Gallbladder contraction | *Gallbladder contraction | ||
*Incomplete and infrequent emptying concentrates bile | *Incomplete and infrequent emptying concentrates bile | ||
*Presence of proteins in the liver and bile causing either promotion or inhibition of cholesterol crystallization into gallstones | *Presence of proteins in the liver and bile causing either promotion or inhibition of cholesterol crystallization into gallstones | ||
*Increased levels of the estrogen hormone may increase cholesterol levels in bile and also decrease gallbladder movement | *Increased levels of the [[estrogen]] hormone may increase cholesterol levels in bile and also decrease gallbladder movement | ||
===Associated Conditions=== | ===Associated Conditions=== | ||
| Line 39: | Line 39: | ||
*[[Primary sclerosing cholangitis|Primary Sclerosing Cholangitis]] | *[[Primary sclerosing cholangitis|Primary Sclerosing Cholangitis]] | ||
*[[Porcelain gallbladder|Porcelain Gallbladder]] | *[[Porcelain gallbladder|Porcelain Gallbladder]] | ||
*Rapid weight loss | *Rapid [[weight loss]] | ||
*Constipation | *[[Constipation]] | ||
*Eating fewer meals | *Eating fewer meals | ||
*Low intake of: | *Low intake of: | ||
**Fish | **Fish | ||
**Magnesium | **[[Magnesium]] | ||
**Folate | **[[Folic Acid|Folate]] | ||
**Whole grain bread | **Whole grain bread | ||
**Fiber | **Fiber | ||
**Vitamin C<ref name="pmid29158491">{{cite journal |vauthors=Lv J, Yu C, Guo Y, Bian Z, Yang L, Chen Y, Li S, Huang Y, Fu Y, He P, Tang A, Chen J, Chen Z, Qi L, Li L |title=Gallstone Disease and the Risk of Type 2 Diabetes |journal=Sci Rep |volume=7 |issue=1 |pages=15853 |year=2017 |pmid=29158491 |doi=10.1038/s41598-017-14801-2 |url=}}</ref><ref>{{cite journal |author=R.M. Ortega |coauthors=M. Fernandez-Azuela, A. Encinas-Sotillos, P. Andres, and A. M. Lopez-Sobaler |year=1997 |month=February |title=Differences in diet and food habits between patients with gallstones and controls |journal=Journal of the American College of Nutrition |volume= 16 |pages=88-95 |accessdate= 2007-08-25}}</ref> | **[[Vitamin C]]<ref name="pmid29158491">{{cite journal |vauthors=Lv J, Yu C, Guo Y, Bian Z, Yang L, Chen Y, Li S, Huang Y, Fu Y, He P, Tang A, Chen J, Chen Z, Qi L, Li L |title=Gallstone Disease and the Risk of Type 2 Diabetes |journal=Sci Rep |volume=7 |issue=1 |pages=15853 |year=2017 |pmid=29158491 |doi=10.1038/s41598-017-14801-2 |url=}}</ref><ref>{{cite journal |author=R.M. Ortega |coauthors=M. Fernandez-Azuela, A. Encinas-Sotillos, P. Andres, and A. M. Lopez-Sobaler |year=1997 |month=February |title=Differences in diet and food habits between patients with gallstones and controls |journal=Journal of the American College of Nutrition |volume= 16 |pages=88-95 |accessdate= 2007-08-25}}</ref> | ||
On the other hand, wine and whole grain bread may decrease the risk of gallstones.<ref>{{cite journal |year=1995 |month=June |title=. |journal=European Journal Gastroenterology & Hepatology |volume=6 |pages=585-593 |accessdate= 2007-08-25}}</ref> | On the other hand, wine and whole grain bread may decrease the risk of gallstones.<ref>{{cite journal |year=1995 |month=June |title=. |journal=European Journal Gastroenterology & Hepatology |volume=6 |pages=585-593 |accessdate= 2007-08-25}}</ref> | ||
Revision as of 13:30, 28 November 2017
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Gallstone disease Microchapters |
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Gallstone disease pathophysiology On the Web |
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American Roentgen Ray Society Images of Gallstone disease pathophysiology |
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Risk calculators and risk factors for Gallstone disease pathophysiology |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]
Overview
It has long been noted that gallbladder stone formation is associated with bile supersaturation, and this still remains the most common cause for gallstone formation.[1]
Pathophysiology
Researchers believe that gallstones may be caused by a combination of factors, including:
- Inherited body chemistry
- Body weight
- Gallbladder motility
- Diet
- Erythropoietic protoporphyria[3]
Cholesterol gallstones develop when bile contains too much cholesterol and not enough bile salts. The following factors also play a role:
- Gallbladder contraction
- Incomplete and infrequent emptying concentrates bile
- Presence of proteins in the liver and bile causing either promotion or inhibition of cholesterol crystallization into gallstones
- Increased levels of the estrogen hormone may increase cholesterol levels in bile and also decrease gallbladder movement
Associated Conditions
- Diabetes Mellitus Type 2
- Obesity
- Pregnancy
- Gallbladder Cancer
- Gallbladder Polyps
- Primary Sclerosing Cholangitis
- Porcelain Gallbladder
- Rapid weight loss
- Constipation
- Eating fewer meals
- Low intake of:
On the other hand, wine and whole grain bread may decrease the risk of gallstones.[6]
Gross Pathology
On gross pathology, multiple small stones are commonly found or less commonly a solitary stone is seen. The smaller stones represent a higher morbidity since they can easily occlude the biliary tracts.[7]
Microscopic Pathology
On microscopic histopathological analysis, variable evidences of inflammation can be noted transmurally including neutrophils, which are characteristic in gallstone disease.[8]
References
- ↑ Wang HH, Portincasa P, Wang DQ (2008). "Molecular pathophysiology and physical chemistry of cholesterol gallstones". Front. Biosci. 13: 401–23. PMID 17981556.
- ↑ name="urlFile:Gallensteine 2006 03 28.JPG - Wikimedia Commons">"File:Gallensteine 2006 03 28.JPG - Wikimedia Commons".
- ↑ "Erythropoietic Protoporphyria". Merck Manual. Retrieved 2007-08-25.
- ↑ Lv J, Yu C, Guo Y, Bian Z, Yang L, Chen Y, Li S, Huang Y, Fu Y, He P, Tang A, Chen J, Chen Z, Qi L, Li L (2017). "Gallstone Disease and the Risk of Type 2 Diabetes". Sci Rep. 7 (1): 15853. doi:10.1038/s41598-017-14801-2. PMID 29158491.
- ↑ 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) - ↑ Ansert, Sandra (2018). Textbook of diagnostic sonography. St. Louis, MO: Elsevier. ISBN 978-0323353755.
- ↑ Fisher, M. M. (1979). Gallstones. Boston, MA: Springer US. ISBN 1461570662.
