Biliary dyskinesia is a disorder that affects how well your gallbladder can do its job. Specifically, it affects the ability of the gallbladder to move bile into the surrounding ducts. The job of the gallbladder is to store bile that is made in the liver. The gallbladder moves the bile into the small intestine when your body is digesting food through a system of ducts that move bile through the digestive system.
Common signs of biliary dyskinesia are:
Biliary dyskinesia is most commonly defined by pain where the gallbladder is, in the right upper part of the abdomen. However, some people may feel it in different areas, like the back or the middle of the abdomen. Episodes of pain often occur after eating and do not occur every day, but the pain is usually fairly severe, often causing hospital visits.
The cause of biliary dyskinesia is unknown. There are potential causes, like a hormonal imbalance regarding the hormones that stimulate digestive processes or the nerves that stimulate muscle contraction in the gallbladder not working properly. Most of the time, it’s hard to pin down exactly what the problem is.
Risk factors for biliary dyskinesia include metabolic disorders, generalised digestive disorders that affect muscle function, and pancreatitis.
Your healthcare provider will take a full medical history and do a physical exam when trying to diagnose biliary dyskinesia. They will look for specific criteria that confirm a potential diagnosis of biliary dyskinesia and rule out other possibilities. These include:
Your provider may ask you to verify specific symptoms, including pain in the upper right side of the abdomen, episodes that occur for 30 minutes or longer, pain that reaches a moderate to severe level, pain that you cannot find relief for, and painful episodes that have been occurring for 3 months or more.
To exclude other possibilities, your healthcare provider may run blood tests to look at the enzyme levels for your gallbladder and liver and they may perform imaging tests of the abdomen to confirm that there are no structural abnormalities that could be causing the pain you’re experiencing.
To confirm a diagnosis, your healthcare provider will perform nuclear medicine imaging, a test that involves injecting a dye and a gallbladder specific hormone into you. It’s a safe way for your provider to check for symptoms while the gallbladder is contracting. They can visualise the movement of the gallbladder and ask what you’re experiencing.
If you experience symptoms during contraction and the gallbladder is putting out less than 50% of its normal volume of bile, you’ll receive a diagnosis of biliary dyskinesia.
Biliary dyskinesia is usually treated by removal of the gallbladder, which has a 90% success rate as a treatment. It is easy to live happily and healthily without a gallbladder, although your digestive system will take a few weeks to adjust. The liver will send bile directly to the small intestine instead.
It isn’t known if biliary dyskinesia goes away on its own, and there are no effective strategies for managing the pain besides gallbladder removal.