biliary dyskinesia

What is Biliary Dyskinesia?

Biliary dyskinesia is a functional gallbladder disorder, meaning that the gallbladder has problems contracting and releasing bile effectively [1]. This leads to a buildup of bile in the gallbladder, causing it to become blocked [2].

Causes and Symptoms

The exact cause of biliary dyskinesia is unknown, but it may be due to metabolic or hormonal changes [6]. The symptoms of this condition are almost identical to those for gallstones and include:

• Sudden, sharp pain in the upper-right side of the abdomen
• Pain after eating
• Intolerance of fatty foods
• Nausea
• Vomiting

These symptoms can be caused by the lack of proper muscular coordination in the gallbladder [8].

Characteristics

Biliary dyskinesia is a functional disorder that occurs when the gallbladder cannot contract and release bile properly [7]. It is also known as a symptomatic functional disorder of the gallbladder, with symptoms mimicking cholelithiasis (gallstones) [9].

In summary, biliary dyskinesia is a condition where the gallbladder has problems contracting and releasing bile, leading to a buildup of bile and causing symptoms similar to those for gallstones.

Common Signs and Symptoms of Biliary Dyskinesia

Biliary dyskinesia, a condition affecting the gallbladder's ability to empty properly, can manifest in various ways. The symptoms can be similar to those experienced with gallstones or other gastrointestinal issues.

• Upper right abdominal pain: This is one of the most common and characteristic symptoms of biliary dyskinesia. The pain is often sharp and sudden, and may radiate to the back or shoulder.
• Pain after eating a meal: Some individuals may experience discomfort or pain in the upper abdomen after consuming food, particularly fatty meals.
• Intolerance of fatty foods: Fatty foods can trigger symptoms like bloating, belching, fullness, nausea, and vomiting due to undigested fats in the intestine.
• Nausea and vomiting: These symptoms may occur independently or in conjunction with abdominal pain.
• Weight loss or gain: Unintentional weight changes can be a sign of underlying issues, including biliary dyskinesia.

Other Possible Symptoms

In some cases, patients may experience:

• Bloating
• Belching
• Fullness
• Dizziness (rarely)
• General abdominal pain, cramps, or spasms

It's essential to note that the symptoms of biliary dyskinesia can vary in severity and frequency among individuals. If you're experiencing any of these symptoms, consult a healthcare professional for proper diagnosis and treatment.

References:

1. [2] Symptoms of biliary dyskinesia include pain in the upper right abdomen, pain after eating, intolerance of fatty foods, nausea, and vomiting.
2. [4] The most common symptom of this condition is abdominal pain. It will most likely be concentrated in the upper right-hand side ...
3. [8] What are the signs and symptoms of biliary dyskinesia? · Pain in your upper right abdomen that lasts at least 30 minutes at a time, and comes and goes · Severe ...
4. [9] Result: upper abdominal pain, cramps, or spasms | general abdominal pain, cramps, or spasms | dizziness | digestive system symptoms

Biliary dyskinesia is a condition characterized by impaired gallbladder emptying and bile flow into the intestine, leading to symptoms such as abdominal pain, nausea, and vomiting.

Diagnostic tests for biliary dyskinesia:

There are several diagnostic tests that may be used to evaluate for biliary dyskinesia. These include:

• Gallbladder ejection fraction (GBEF) test: This is a radionuclide investigation that measures the percentage of radioactive tracer released from the gallbladder into the bile ducts over a 60-minute period. An abnormal GBEF has been associated with biliary dyskinesia [3].
• Hepatobiliary iminodiacetic acid (HIDA) scan: This is an imaging procedure that uses a radioactive tracer to visualize the flow of bile from the liver through the gallbladder and into the intestine. A HIDA scan can help diagnose problems with bile flow and identify biliary dyskinesia [6].
• CCK-HIDA scan: This test combines a cholecystokinin (CCK) challenge with a HIDA scan to assess gallbladder emptying and bile flow in response to CCK stimulation. CCK-HIDA scans have been shown to be useful for diagnosing biliary dyskinesia and predicting improvement after cholecystectomy [8].
• Liver Function Test: This is a blood test that measures the levels of certain enzymes and proteins in the liver, which can indicate liver damage or dysfunction.
• Physical examination and clinical suspicion: Your doctor will assess your symptoms and perform a physical exam to determine if biliary dyskinesia is likely.

It's worth noting that a period of observation may be offered before proceeding with diagnostic tests [1]. A diagnosis of biliary dyskinesia can only be made by performing these diagnostic tests, which are usually ordered by a surgeon or gastroenterologist.

Treatment Options for Biliary Dyskinesia

Biliary dyskinesia, a condition characterized by gallbladder dysfunction and pain, can be challenging to treat. While there is no definitive cure, various treatment options are available to manage symptoms and improve quality of life.

• Litholytic agents: Studies have shown that litholytic agents can improve biliary colic in patients with biliary dyspepsia [3][8]. These agents present an alternative treatment modality for biliary dyskinesia.
• Pain management: Nonsteroidal anti-inflammatory drugs (NSAIDs) or narcotic pain relievers are commonly used to manage pain associated with acute biliary colic and biliary dyskinesia [12].
• Proton pump inhibitors: Some studies suggest that proton pump inhibitors may be effective in managing symptoms of biliary dyskinesia, although the evidence is limited [10].

Surgical Intervention

In most cases, treatment for biliary dyskinesia involves surgical removal of the gall

Differential Diagnosis of Biliary Dyskinesia

Biliary dyskinesia, a functional gallbladder disorder, requires careful differential diagnosis to rule out other conditions that may cause similar symptoms. Here are some key points to consider:

• Sphincter of Oddi dysfunction: This condition can mimic the symptoms of biliary dyskinesia, including right upper quadrant pain and nausea [2].
• Abdominal disorders: Conditions such as peptic ulcer disease, hepatitis, cholangitis, mesenteric ischemia, pancreatitis, renal calculi, viral or bacterial gastroenteritis, and other abdominal issues should be ruled out in the differential diagnosis [5][6][7].
• Cholelithiasis (gallstones): Although biliary dyskinesia is characterized by the absence of gallstones, it's essential to consider cholelithiasis as a potential cause of right upper quadrant pain [8].
• Biliary sludge: This condition can also cause similar symptoms and should be considered in the differential diagnosis [8].
• Gallbladder microcalculi: These small stones or particles within the gallbladder can cause recurrent right upper quadrant pain, making them a potential differential diagnosis for biliary dyskinesia [8].
• Cholesterol polyps: Although rare, cholesterol polyps can cause similar symptoms and should be considered in the differential diagnosis [8].

It's crucial to note that a thorough medical evaluation, including imaging studies and laboratory tests, is necessary to accurately diagnose biliary dyskinesia and rule out other potential causes of right upper quadrant pain.

References:

[2] May 2, 2018 — Sphincter of Oddi dysfunction is an uncommon, probably overdiagnosed, cause of biliary-type pain. [5] Aug 15, 2020 — Biliary dyskinesia should be differentiated from other disorders that caused right upper quadrant (RUQ) pain, such as: Abdominal disorders ... [6] The differential diagnosis of upper abdominal pain in patients with an intact gallbladder but without gallstones is broad, including peptic ulcer disease, SOD, ... [7] by DF Sigmon · 2023 · Cited by 19 — Differential Diagnosis. Hepatitis. Cholangitis. Mesenteric ischemia. Pancreatitis. Renal calculi. Viral or bacterial gastroenteritis. Biliary dyskinesia. [8] Dec 25, 2016 — Differential diagnosis · sphincter of Oddi dysfunction · cholelithiasis · biliary sludge · gallbladder microcalculi · cholesterol polyps ...