Gallstones Pathogenesis

Dietary factors may also be important in gallstone pathogenesis - such as intake of total calories, cholesterol, refined carbohydrates and dietary fibre. As discussed below, the amount of bran, and of other fibre components, in the diet may influence the formation of deoxycholic acid (DCA) in the intestine, its subsequent absorption and its enrichment of bile with DCA conjugates. 

Grundy, S.M. Cholesterol—Bile acid interactions in gallstone pathogenesis. Hosp. Prac. 8, 57-65 (1973)... 

The Role of Prolonged Intestinal Transit in the Pathogenesis of Conventional Cholesterol Gallstones... 

Isogai M, Hachisuka K, Yamaguchi A, Nakano S. Etiology and pathogenesis of marked elevation of serum transaminase in patients with acute gallstone disease. HPB Surg 1991 4 95-105 discussion 6-7. 

These results raise the question of whether these amorphous stones containing calcium bile salts could be related to the pathogenesis of the cholesterol stones. Glycine-conjugated bile salts, particularly of the less soluble compounds such as chenodeoxycholate and lithocholate, have been found in greater proportions in the centers of human gallstones (167), and it would be of interest to know whether this is the case in the cholesterol stones that frequently coexisted in these animals. 

The pathogenesis of gallstones can essentially be reduced to a matter of solubility of the various solutes that constitute the stone—cholesterol in cholesterol stones and cholesterol, calcium carbonate, phosphate, or bilirubinate in mixed stones. 

The application of the fundamental knowledge, gained during the last decade, of the pathogenesis of cholesterol gallstones, allowed the actual placing of medical cholelitholysis with chronic administration of bile acids. 

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