The Role of Gut Flora in the Formation of Gallstones

Gallstones represent a widespread digestive system condition globally, predominantly manifesting as cholesterol-based calculi. Historical understanding has focused on metabolic and liver-biliary mechanisms as primary causative factors; recent research, however, increasingly demonstrates that intestinal microbial communities significantly contribute to gallstone development. The gut microbiome affects bile acid (BA) processing, cholesterol regulation, and the enterohepatic cycle. Microbial imbalances may lead to modifications in BA composition and inflammatory responses, increasing susceptibility to stone formation. This article consolidates existing research examining how intestinal bacteria influence gallstone pathogenesis, underlying biological mechanisms, clinical relevance, and potential treatment strategies.