An update on the pathogenesis of cholesterol gallstone disease

Abstract

Ongoing research on cholesterol gallstone disease is intensively investigating several pathogenic mechanisms, associated metabolic disorders, new therapeutic approaches, and novel strategies for primary prevention, including lifestyles.

Distinct Effects of two Almond Cultivars on Agreeability and Gastrointestinal Motility in Healthy Subjects: more than mere Nutraceuticals

“…Almonds consumption is inversely associated with the incidence of cardiovascular disease [4,[67][68][69] and with body weight [66,[70][71][72]. FCcv, with higher lipid content than CAcv might act as a "natural" prokinetic agent on a hypomotile gallbladder, a condition at increased risk for biliary sludge or cholesterol cholelithiasis [73]. Also, FCcv, highly enriched in phenol content, could better counteract the ongoing oxidative stress in several chronic metabolic disorders.…”

Gastrointestinal defects in gallstone and cholecystectomized patients

“…This type of visceral stasis is a clear predisposing factor towards accumulation of concentrated supersaturated bile and hypersecretion of mucin gel from the gallbladder epithelium during the immune‐mediated gallbladder inflammation. Additional factors involve intestinal cholesterol absorption, defective intestinal motility and changes of the gut microbiota . The presence of a hypomotile gallbladder, both in the fasting state and in response to neuro‐hormonal postprandial stimuli, plays an important role.…”

“…The presence of a hypomotile gallbladder, both in the fasting state and in response to neuro‐hormonal postprandial stimuli, plays an important role. Gallbladder hypomotility, in fact, is one of the major pathogenic factors contributing to the accumulation of excess biliary cholesterol in the gallbladder lumen, as well as precipitation of solid cholesterol crystals, a key step in the further growth of gallstones . This study assessed gallbladder motility in patients with cholesterol gallstones, but a type of intermediate motility defect also exists in patients with pigment stones …”

“…Additional factors involve intestinal cholesterol absorption, defective intestinal motility and changes of the gut microbiota. 47,48 The presence of a hypomotile gallbladder, both in the fasting state 49,50 and in response to neurohormonal postprandial stimuli, 16,51,52 plays an important role. Gallbladder hypomotility, in fact, is one of the major pathogenic factors contributing to the accumulation of excess biliary cholesterol in the gallbladder lumen, 47,52 as well as precipitation of solid cholesterol crystals, a key step in the further growth of gallstones.…”

“…Gallbladder hypomotility, in fact, is one of the major pathogenic factors contributing to the accumulation of excess biliary cholesterol in the gallbladder lumen, 47,52 as well as precipitation of solid cholesterol crystals, a key step in the further growth of gallstones. 48 This study assessed gallbladder motility in patients with cholesterol gallstones, but a type of intermediate motility defect also exists in patients with pigment stones. 53,54 Gallbladder kinetics depends on about 60 to 80% of its reduction on vagal cholecystokinin-mediated mechanisms, which lead to expulsion and increased intraluminal concentrations of bile acids (BA).…”