Researchers discovered that people with gallstones have different types of fungi living in their gut compared to healthy people. In mouse studies, they found that certain fungi can increase gallstone formation, while an antifungal medication reduced gallstone development. The study suggests that imbalances in gut fungi may trigger immune responses in the liver that lead to gallstones. While these findings are promising, more research in humans is needed before doctors might use antifungal treatments to prevent gallstones.

The Quick Take

  • What they studied: Whether imbalances in gut fungi (tiny organisms living in your intestines) contribute to gallstone formation and whether antifungal medication could prevent gallstones
  • Who participated: The study included gallstone patients and healthy volunteers for comparison, plus laboratory mice that were fed a diet designed to cause gallstones
  • Key finding: Mice treated with fluconazole (an antifungal medication) developed fewer gallstones compared to untreated mice. Additionally, introducing a specific fungus called Rhodotorula mucilaginosa increased gallstone formation in mice
  • What it means for you: This research suggests gut fungi imbalance may contribute to gallstone risk, but it’s still early-stage research. Don’t take antifungal medications for gallstone prevention without talking to your doctor, as this hasn’t been tested in humans yet

The Research Details

This study combined observations from human patients with controlled experiments in mice. First, researchers compared the types and amounts of fungi in the guts of gallstone patients versus healthy people. They found significant differences in fungal composition and diversity. Next, they conducted mouse experiments where some mice received fluconazole (a medication that kills fungi) while eating a special diet known to cause gallstones. Other mice were given specific fungi to see if it worsened gallstone formation. The researchers then examined liver tissue under microscopes and analyzed genetic activity to understand how fungi might trigger gallstone development.

Most previous research on gut health and gallstones focused only on bacteria, largely ignoring fungi. This study is important because it shows fungi may be equally important. By using both human observations and controlled mouse experiments, the researchers could establish a potential cause-and-effect relationship rather than just finding a correlation

The study used multiple complementary approaches (comparing patients, animal models, microscopic analysis, and genetic sequencing) which strengthens confidence in the findings. However, the research was conducted primarily in mice, which don’t always behave the same as humans. The study hasn’t been tested in human patients yet, so we can’t be certain these results apply to people

What the Results Show

Patients with gallstones showed different fungal communities in their guts compared to healthy people, with increased fungal diversity and altered composition. When mice received fluconazole treatment, they developed significantly fewer gallstones despite eating a gallstone-promoting diet. Conversely, when researchers introduced Rhodotorula mucilaginosa (a specific fungus) into mice, gallstone formation increased. These results suggest a direct link between specific gut fungi and gallstone development. The mechanism appears to involve the fungi triggering immune cells in the liver called neutrophils to form structures called neutrophil extracellular traps, which may damage tissue and promote gallstone formation.

Genetic analysis revealed that fluconazole affects multiple pathways in the liver related to gallstone formation, not just a single mechanism. The study also found that fungal-bacterial interactions (how fungi and bacteria work together in the gut) were altered in gallstone patients, suggesting the entire microbial community balance matters

Previous research established that gut bacteria influence gallstone risk, but this is among the first studies to examine fungi’s role. This work expands our understanding by showing that fungi, though a smaller portion of gut microorganisms, may be equally important. It aligns with growing evidence that overall microbial balance—not just individual organisms—affects metabolic health

The main limitation is that all experiments were conducted in mice, which have different biology than humans. The study didn’t specify exact sample sizes for human participants. The research doesn’t prove that treating gallstone patients with antifungal medication would work the same way it did in mice. Additionally, the study doesn’t explain why some people develop fungal imbalances while others don’t

The Bottom Line

This research is preliminary and shouldn’t change current medical practice. Current gallstone treatment and prevention approaches remain unchanged. If you have gallstones or are concerned about gallstone risk, consult your doctor about established prevention strategies like maintaining a healthy weight and balanced diet. Do not take antifungal medications for gallstone prevention without medical supervision, as this approach hasn’t been proven safe or effective in humans

This research is most relevant to people with a family history of gallstones, those with obesity, or anyone interested in gut health. Gastroenterologists and researchers studying gallstone disease should pay attention. However, the general public should view this as interesting early-stage research rather than actionable medical advice

If these findings eventually lead to human treatments, it would likely take 5-10 years of additional research before antifungal approaches might become a clinical option. Current gallstone prevention and management strategies remain the most evidence-based approaches

Want to Apply This Research?

  • Track digestive symptoms (bloating, discomfort, changes in bowel habits) weekly, as these may relate to gut health. Note any dietary changes and how you feel, creating a personal baseline for gut wellness
  • Focus on maintaining a balanced diet rich in fiber and whole foods, which supports healthy gut microbial communities. Avoid rapid weight loss and limit high-fat foods, both established gallstone risk factors. Log these dietary choices in your app to monitor patterns
  • Set monthly reminders to assess overall digestive wellness and energy levels. If you have risk factors for gallstones, discuss regular check-ups with your doctor and track any symptoms that emerge. Use the app to maintain a food and symptom diary that you can share with healthcare providers

This research is preliminary and has only been tested in mice, not humans. Do not change your gallstone prevention or treatment approach based on this study. If you have gallstones, symptoms of gallstones, or concerns about gallstone risk, consult with your healthcare provider about evidence-based treatment and prevention options. Do not take antifungal medications without medical supervision. This summary is for educational purposes and should not be considered medical advice.