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What is Gall blader stone formation in influenced by A/E ? and explain in detail?
Ans is 'd' i.e., Hypercholesterolemia Hyperalimentation - decreases gall bladder motility, promotes stasis Primary biliary cirrhosis - decreases bile salt secretion into bile Clofibrate therapy - increases biliary cholesterol - thus these factors predispose to cholesterol stone formation. Predisposing factors for cholesterol gall stone formation are 1. Demographic/genetic factors Prevalence highest in Noh American Indians, Chilean Indians and Chilean Hispanics, greater in Nohern Europe and Noh America than in Asia, lowest in Japan; familial disposition; hereditary aspects. 2. Obesity a. Normal bile acid pool and secretion but increased biliary secretion of cholesterol 3. Weight loss a. Mobilization of tissue cholesterol leads to increased biliary cholesterol secretion while enterohepatic circulation of bile acid is increased 4. Female sex hormones a. Estrogens stimulate hepatic lipoprotein receptors, increases uptake of dietary cholesterol, and increase biliary cholesterol secretion b. Natural estrogens, other estrogens, and oral contraceptives lead to decreased bile salt secretion and decreased conversion of cholesterol to cholesteryl esters. 5. Increasing age a. Increased biliary secretion of cholesterol, decreased size of bile acid pool, decreased secretion of bile salts. 6. Gallbladder hypomotility leading to stasis and formation of sludge Prolonged parenteral nutrition Fasting Pregnancy Drugs such as octreotide 7. Clofibrate therapy a. Increased biliary secretion of cholesterol 8. Decreased bile acid secretion Primary biliary cirrhosis Genetic defect of the CYP7A1 gene 9. Decreased phospholipid secretion a. Genetic defect of the MDR3 gene 10. Miscellaneous High-calorie, high fat diet Spinal cord injury