Re: trillion dollar question

1. There are a number of genes that influence the formation of bile which allow the bile to thicken.
2. Pregnancy; the changes in oestrogen levels have a profound effect o the biliary system by increasing cholesterol saturation.
3. Sudden weight loss.
4. Certain medication such amitriptyline which delays stomach emptying and interferes with the digestive process to a degree where the bile stagnates.
5. Recreational drugs and substances; eg, opioids paralyse the digestive system.
6. Liver injury caused by alcohol.
7. Poor digestion of the ilium part of the small intestines.
8. Others conditions that upset the fine balance of the metabolism and contribute to a lifestyle conducive to biliary stasis.

Read more with this article in the link below:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110573/

In all cases where the ilium is difunctional the biliary system is also dysfunctional. It's difficult to correct the biliary system until the bowel is working properly and the cycling of bile, called the entero-hepatic circulation is restored.

Regards Telman