C-C2W is the physical cause of cholesterol gallstones.

Cholesterol gallstones are made up of cholesterol.H20, traces of body temperature cholesterol, and a cholesterol-cholestanol-water adduct (C-C-2W). For the first time C-C-2W has been chemically and optically located in such gallstones, specifically in the nucleus, in the groove, and on the surface. These findings suggest a novel yet rational theory of cholesterol-stone quantitatively related to prevention and dissolution: (1) Bile is chemically abnormal if cholestanolH2O is present as a foreign unwanted substance. (2) When cholestanol.H2O in portal blood approaches 10(-4) mg/ml, precipitation of C-C-2W occurs in the hepatocytes because it finds sufficient cholesterol.H2O to reach the solubility product of the adduct. The resulting C-C-2W microcrystallites flow with bile down the biliary tree and then seed the supersaturated cholesterol solution in the gallbladder. (3) On the other hand, for concentrations of cholestanol.H2O around 10(-5) mg/ml, C-C-2W precipitation occurs exclusively in the gallbladder. (4) The adduct is the physical cause of cholesterol gallstones since however it arrives in the gallbladder, it produces swift crystallization of cholesterol.H20.