Gallstones Pathophysiology 

Cholesterol gallstones develop when bile contains too much cholesterol & not enough bile salts. Besides a high concentration of cholesterol, 2 other factors are important in causing gallstones. The first is how often & how well the gallbladder contracts incomplete & infrequent emptying of the gallbladder might cause the bile to become overconcentrated & contribute to gallstone formation. The second factor is the presence of proteins in the liver & bile that either promote or inhibit cholesterol crystallization into gallstones. In addition, increased levels of the hormone estrogen as a result of pregnancy, hormone therapy, or the use of combined forms of hormonal contraception, might increase cholesterol levels in bile & also decrease gallbladder movement, resulting in gallstone formation.