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Causes and Risk Factors

Causes of Gallbladder Disease & Gallstones

Your gallbladder can cause problems if something blocks the flow of bile through the cystic duct. The most common cause of blockage is a gallstone. Doctors believe stones form when bile contains too much cholesterol or bilirubin (a waste product), not enough bile salts or if the gallbladder does not empty correctly.

Have gallstones may cause more gallstones to form. Other factors that cause gallstones, particularly cholesterol stones, include:1


Women are twice as likely as men to develop gallstones. Excess estrogen from pregnancy, hormone replacement therapy, and birth control pills may increase cholesterol levels in bile and decrease gallbladder movement, which can lead to gallstones.


Gallstones often run in families.


Even being mildly overweight increases your risk for having gallstones. The most likely reason is that the amount of bile salts in bile is reduced, and this results in increased cholesterol. The gallbladder does not empty fully with increased cholesterol. Obesity is a major risk factor for gallstones, especially in women.


Diets high in fat and cholesterol and low in fiber increase the risk of gallstones due to increased cholesterol in the bile and reduced gallbladder emptying.

Rapid weight loss:

As the body processes fat during fasting and rapid weight loss, including "crash diets," the liver secretes extra cholesterol into bile, which can cause gallstones. Also, the gallbladder does not empty properly.


People older than age 60 are more likely to develop gallstones. As we age, the body tends to secrete more cholesterol into bile.


American Indians have a genetic predisposition for high levels of cholesterol in bile. In fact, they have the highest rate of gallstones in the United States. Hispanic men and women of all ages in the U.S. also have high rates of gallstones.

Cholesterol-lowering drugs:

Drugs that lower cholesterol levels in the blood actually increase the amount of cholesterol secreted into bile. As a result, the risk of gallstones increases.


People with diabetes generally have high levels of fatty acids called triglycerides. These fatty acids may increase the risk of gallstones.

The cause of pigment stones is not fully understood. These stones tend to develop in people who have liver cirrhosis (scarring of the liver), biliary tract infections, or hereditary blood disorders—such as sickle cell anemia—in which the liver makes too much bilirubin.

PN 1002276 Rev A 04/2013

  1. National Digestive Diseases Information Clearinghouse, www.digestive.niddk.nih.gov, URL: http://digestive.niddk.nih.gov/ddiseases/pubs/gallstones/#3

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