Risk factors for gallstones

The typical patient is said to be the "fair, fat, fertile, female of forty", but many gallstone patients do not fit this description (1).

An imbalance between pronucleating factors and antinucleating factors in the bile leads to formation of cholesterol stones. The main risk factors for cholesterol stone formation are;

• female sex
• pregnancy
• high dose oestrogen treatment
• increasing age
• ethnicity (higher prevalence in Native American Indians and lower prevalence in black Americans, Africans, and people from China, Japan, India, and Thailand)
• genetic traits
• obesity
• high serum triglyceride levels
• low levels of high density cholesterol
• rapid weight loss
• high calorific diet
• refined carbohydrate diet
• lack of physical activity
• cirrhosis
• Crohn's disease
• gallbladder stasis (for example, as a result of previous gastrectomy or vagotomy).

The main risk factors for pigment stone include:

• haemolysis
• chronic bacterial or parasitic infections (2)

Reference:

• (1) Croton R. The basics - The management of gallstones. GPonline 2011
• (2) Gurusamy KS, Davidson BR. Gallstones. BMJ. 2014;348:g2669