Causes of cholesterol stones

Cholesterol stones, the most common type of gallstones, account for at least 80 percent of all cases. They form when three conditions exist:

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• The bile must be supersaturated with cholesterol, meaning it contains a very large amount compared with the other components of bile.
• The cholesterol in bile must rapidly transform into crystals.
• There must be a decrease in gallbladder contractions. Without proper movement of the gallbladder cholesterol, crystals in the bile remain in the gallbladder long enough to form stones.

Factors that appear to create or encourage these conditions include:

• Use of hormone replacement therapy and birth control pills. These drugs appear to raise the level of cholesterol in bile and also reduce gallbladder movement.
• Use of cholesterol-lowering drugs. Medications such as clofibrate reduce the amount of cholesterol in blood but raise the level in bile.
• Pregnancy. Extra estrogen in a pregnant woman's system results in supersaturation of the bile with cholesterol and decreased gallbladder movement.
• Rapid weight loss. Gallstone formation is one of the most frequent and significant complications of rapid weight loss. Cholesterol is activated from fatty tissue and secreted into the bile, leading to both cholesterol supersaturation and diminished gallbladder contractions. Studies of people on very low calorie weight-loss plans or among people who experience rapid weight loss resulting from gastric bypass surgery indicate that gallstone formation is a common unwanted side effect. Fasting also decreases gallbladder movement and causes bile to overconcentrate cholesterol, leading to gallstones.