Biliary Dyskinesia

What is Biliary Dyskinesia

Biliary dyskinesia is a condition in which the gallbladder or bile ducts cannot release or move bile normally. Bile is a fluid that is made in the liver. It helps the body to digest food.

Bile flows to the gallbladder to be stored. When bile is needed for digestion, it leaves the gallbladder and flows through the bile ducts into the digestive tract. Biliary dyskinesia causes bile to build up, and that can cause abdomen (abdominal)pain.

This condition may also be called:

• Acalculous cholecystopathy.
• Functional gallbladder disorder.
• Sphincter of Oddi dysfunction.

All these names describe gallbladder disorders that are not caused by gallbladder stones. Sphincter of Oddi dysfunction happens in the area where the duct for digestive juices from the pancreas (pancreatic duct) joins the bile duct before emptying into the digestive tract. If the opening into the digestive tract is too small, bile and pancreatic juices may back up and cause abdominal pain.

What are the causes?

The cause of biliary dyskinesia is poor function of the gallbladder. The exact reason this happens is often unknown. One reason may be changes in the gallbladder that are caused by obesity.

What increases the risk?

You are more likely to develop this condition if your mother or father had it, or if you are:

• Overweight.
• Female.
• 40–60 years old.

What are the signs or symptoms?

The main symptom of this condition is pain in the upper right side of the abdomen. Typically, the pain:

• Starts about 30 minutes after a meal, especially a meal that is spicy or greasy.
• Lasts for 30 minutes or longer.
• Builds up gradually until it is a steady pain that is severe enough to interrupt daily activities.

Other symptoms may include:

• Nausea.
• Vomiting.
• Cramping.
• Bloating.
• Heartburn.
• Diarrhea.

How is this diagnosed?

This condition may be diagnosed based on your symptoms, your medical history, and a physical exam. You may have tests to rule out other conditions and to confirm the diagnosis. These may include:

• Blood tests.
• Ultrasound tests of the gallbladder.
• HIDA scan. This is an X-ray test that can show if your gallbladder empties less than a normal amount of bile (gallbladder ejection fraction).
• MRI or CT scan of the abdomen.
• ERCP (endoscopic retrograde cholangiopancreatogram). During this procedure, a thin tube with a camera on the end is inserted into the throat and down into areas that need examination, such as the pancreas, bile ducts, liver, and gallbladder. Dye is injected into your blood, then X-rays are done. The dye helps your health care provider to see the areas that need examination. ERCP may be done to help diagnose sphincter of Oddi dysfunction.

How is this treated?

Treatment depends on the cause. The first step of treatment is usually to make lifestyle changes. Your health care provider may recommend:

• Taking over-the-counter or prescription pain medicine.
• Resting.
• Losing weight.
• Avoiding foods that are spicy or greasy.

In some cases, the condition gets better with lifestyle changes only. However, in many cases, surgery to remove the gallbladder (cholecystectomy) is necessary.

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do notdrive or use heavy machinery while taking prescription pain medicine.
• If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
  • Take an over-the-counter or prescription medicine for constipation.
• Rest and return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Follow instructions from your health care provider about eating or drinking restrictions. You may need to limit fatty, greasy, and spicy foods if they cause symptoms.
• Limit alcohol intake to no more than 1 drink a day for nonpregnant women and 2 drinks a day for men. One drink equals 12 oz of beer, 5 oz of wine, or 1½ oz of hard liquor. Alcohol can irritate your stomach and your liver.
• Do notuse any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider. Smoking can damage your digestive system.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• Your abdominal pain comes back.
• You have any of the following:
  • Nausea.
  • Vomiting.
  • Diarrhea.
  • Cramping.
  • Bloating.
  • Diarrhea.

Summary

• Biliary dyskinesia is a condition in which your gallbladder or bile ducts cannot release or move bile normally.
• The main symptom of this condition is pain in the upper right side of the abdomen. The pain typically starts about 30 minutes after a meal, especially a meal that is spicy or greasy.
• Treatment may include lifestyle changes, such as working to lose weight and avoiding certain foods. In many cases, surgery to remove the gallbladder (cholecystectomy) is necessary.