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.
