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What is Gallbladder Dyskinesia?
Gallbladder dyskinesia, or biliary dyskinesia, is a disease where there is incomplete emptying of the gallbladder. Normally a substance called bile leaves the gallbladder through a tube known as the bile duct but, with gallbladder dyskinesia, the gallbladder is not able to contract normally in order to pump bile out. The person experiences similar symptoms to someone with gallstones, where the bile duct is blocked by stones. Symptoms of gallbladder dyskinesia typically include nausea and pain in the upper right side of the abdomen, often experienced after eating fatty foods. Treatment commonly involves surgical removal of the gallbladder.
The onset of gallbladder dyskinesia may be quite sudden if it occurs in association with another illness. On recovery from the illness, the dyskinesia may go away and not return. Gallbladder dyskinesia may also develop gradually over a longer period, when it is thought to be caused by reduced movement, often referred to as a motility disorder, affecting the muscles that control gallbladder emptying.
Symptoms of gallbladder dyskinesia may involve pain experienced in the hours following a meal. The pain is typically felt on the right hand side of the body, in the upper part of the abdomen. Sometimes the pain may seem to penetrate through to the shoulder blade. It often occurs after eating fatty or spicy foods, and may be accompanied by nausea and bloating.
As the symptoms of a person with gallbladder dyskinesia are very similar to those of someone who has gallstones, investigations are necessary to make a diagnosis. Ultrasound scans may be carried out, as well as endoscopy, where a slender viewing instrument is passed through the mouth to investigate the stomach and upper intestines. If there is no evidence of gallstones, nuclear medicine scans are used to examine how well the gallbladder is emptying. A radioactive substance is injected which collects in bile, and a hormone is given to make the gallbladder contract. Meanwhile, a nuclear camera picks up an image of the gallbladder in action and the amount of bile expelled can be measured.
If little or no bile is expelled from the gallbladder, this suggests dyskinesia. Generally, the condition is treated by a procedure known as cholecystectomy, where the gallbladder is surgically removed. The operation may be carried out using keyhole surgery, where only small incisions are made, and patients do not need to stay in the hospital overnight.
In most cases, people experience an improvement of some, or all, of their symptoms following surgery. Although bile is needed to digest food, removal of the gallbladder does not prevent digestion. The gallbladder's function is to store bile, which is made in the liver, and, following cholecystectomy, the only difference is that bile continuously drains into the gut instead of being stored and released after meals.
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![A healthy gallbladder and one with gallstones.]()
By: AlilaA healthy gallbladder and one with gallstones. -
![An ultrasound can be used to diagnose gallbladder dyskinesia.]()
By: acherstAn ultrasound can be used to diagnose gallbladder dyskinesia. -
![One symptom of gallbladder dyskinesia is pain in the upper right side of the abdomen.]()
By: starasOne symptom of gallbladder dyskinesia is pain in the upper right side of the abdomen. -
![An endoscopy may be performed to distinguish gallbladder dyskinesia from other similar conditions.]()
By: Stephan MorroschAn endoscopy may be performed to distinguish gallbladder dyskinesia from other similar conditions. -
![Nausea is a possible symptom of gallbladder dyskinesia.]()
By: Piotr MarcinskiNausea is a possible symptom of gallbladder dyskinesia. -
![Pain from gallbladder dyskinesia can sometimes penetrate through to the shoulder blade.]()
By: Photographee.euPain from gallbladder dyskinesia can sometimes penetrate through to the shoulder blade. -
![Treatment for gallbladder dyskinesia may include surgical removal of the gallbladder.]()
By: dacasdoTreatment for gallbladder dyskinesia may include surgical removal of the gallbladder. -
![Symptoms of gallbladder dyskinesia are very similar to those of someone who has gallstones.]()
By: designuaSymptoms of gallbladder dyskinesia are very similar to those of someone who has gallstones.
Discussion Comments
I had terrible pain in my right upper quadrant, with bowel issues including constipation, loose bowels, and gas. I went to the ER and described what had been going on for six months. I was afraid I had colon cancer. They did a CT with contrast and sent me home saying it was constipation.
I went to a GI MD that I had seen six years before. He told me I was clinically depressed! I had severe pain. He reluctantly referred me to have a HIDA scan. My ejection fraction was 10%. I returned to his office. I was having terrible chest pressure and pain. He said he wanted to do a EGD first because he thought I had an ulcer. He said the EGD was normal but with some stomach inflammation. The following day I went to an Urgent MD where my BP was 176/110! They prescribed a medication for nausea that would also help with pain. I took one pill and it worked for two days. The GI MD completely disregarded my elevated BP at the office appointments. He said it was all due to depression, which he told my spouse while I was waking up. I heard him say it! I was so frustrated.
He referred me to a surgeon. My appointment is like a month away just for the consult, not the surgery. I wonder if the GI doctor would tolerate the pain I've had for months if it were him. I'm guessing no. I don't think he would say it's all in his head.
After the appointment for surgical consult was made, he sent me a letter basically saying he could find nothing. I'm thinking he doesn't want to accept responsibility for telling me it was all related to depression. Why would a MD ignore high BP? I am not a doctor. It is a doctor's job to help the patient. He could have done blood work or referred me to a cardiologist or something. He never listened to my bowel sounds with a stethoscope. He ruled out what he could by the HIDA scan and since he didn't find what he was looking for with the EGD, he wrote me off. The ER doctor never even palpated my abdomen. All he did was sit there and ask me questions and order the CT with contrast. Only based on what I told him, he said I was constipated and sent me home. These doctors always tell $700. I am so sick of this crap. I can't even lead a normal life.
I had the HIDA scan today, and it was not fun. Basically, the technician fills your liver with a radioactive material and you are scanned for an hour. Then they give you an enzyme that mimics a fatty meal. I immediately had a gall bladder attack. She knew what was coming, but I did not. I only had 7.2 percent of function.
Couldn't the doctor tell if I had a "mushy" gall bladder without the attack with a simple ultrasound? I have been eating almost nothing for 8 weeks because I didn't want to have another attack. My doctor didn't think my pain description was indicative of a poorly functioning gall bladder, even though my mom and grandmother had "mushy" gall bladders with no stones. By the way, the term mushy came from a doctor, not my term. Can't wait to have it out.
So, whether you have gallstones or a malfunctioning gallbladder, the treatment of choice is to remove the doggone thing.
Seems to me it's something of a waste of time to go through all that testing just to prove it's dyskinesia, if all the symptoms point to a bad gallbladder, whether "bad" refers to stones or it not emptying properly.
I suppose a doctor has to be certain that's what he's dealing with, but gallstones are a form of dyskinesia as well, since that word means "poor function." If a person has gallstones, his gallbladder is not functioning properly. But, the diagnosis has to be accurate.
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