Cholelithiasis

1. epidemiology

   • affects 20% of Americans, 20% of which become symptomatic within 20 years.

2. classification

   • 70% are cholesterol stones (cholesterol and calcium) 2/2 diet.

   • 30% are pigment stones (bilirubin) 2/2 hemolysis and/or cirrhosis.

3. risk factors

   • ↑age, female

   • pregnancy

   • DM2, HLD, obesity

   • meds (fibrates, ceftriaxone, octreotide, HRT, OCPs)

   • rapid weight loss, fasting, TPN

   • spinal cord injury

   • cirrhosis

   • Crohn disease

   • hyperbilirubinemia

MNEMONIC: Forty, Female, Fat, Fertile