People with gallstones made of cholesterol have stiffer cell membranes in their gallbladder muscles, which might make the gallbladder less able to squeeze and empty properly.

We analyzed the available evidence and found that 20 studies or assertions support the idea that cholesterol gallstones are linked to stiffer cell membranes in the gallbladder muscle, which may affect how well the gallbladder contracts and empties [1]. No studies or assertions in our review contradicted this. The gallbladder is a small organ that stores bile and releases it when needed, especially after eating fatty meals. For this to work, its muscle walls need to be flexible enough to squeeze tightly. What we’ve found so far suggests that when gallstones are made mostly of cholesterol, the cell membranes in the gallbladder muscle may become less flexible, possibly making it harder for the organ to contract properly. This doesn’t mean the gallbladder stops working entirely, but it may not empty as efficiently as it should. We don’t know yet if the stiffness comes from the cholesterol in the stones themselves, or from other changes in the tissue caused by long-term stone presence. We also don’t know if this stiffness happens before or after the stones form. The evidence we’ve reviewed doesn’t show whether this stiffness causes symptoms like pain or bloating, or if it’s just a side effect. So far, the pattern is consistent: cholesterol gallstones appear to go hand-in-hand with reduced flexibility in the gallbladder muscle. But we can’t say this is the only reason for poor gallbladder function, or if other factors are involved. If you have cholesterol gallstones and notice discomfort after meals, especially fatty ones, it may be worth discussing gallbladder emptying with a healthcare provider — but don’t assume stiffness is the only cause. More research is needed to understand how these changes develop and what they mean for daily health.