Biliary dyskinesia is a disease where the gallbladder fails to contract properly, causing abdominal pain. Diagnostic tests are needed to rule out gallstones before treatment, which often involves gallbladder removal.
Biliary dyskinesia is a disease of the gallbladder. The gallbladder stores bile from the liver and releases it into the small intestine, where it breaks down fats eaten during meals. Bile travels from the gallbladder through the common bile duct to the small intestine. If bile is not secreted from the gallbladder or fails to pass through the common bile duct, it will flow back into the gallbladder, causing biliary dyskinesia.
When a person ingests a meal, a hormone known as cholecystokinin is secreted by cells in the small intestine. Cholecystokinin binds to receptors distributed in the muscle of the gallbladder and this causes contraction of the gallbladder. The bile is emptied from the gallbladder and travels to the small intestine. If a patient has biliary dyskinesia, the gallbladder does not contract properly.
There are three round muscles at the end of the common bile duct which are known as the sphincter of Oddi. In addition to causing the gallbladder to contract, the hormone cholecystokinin binds to receptors on the sphincter of Oddi and signals these muscles to relax. The bile can then flow into the small intestine. If the sphincter of Oddi muscles aren’t working properly, bile won’t pass through the common bile duct; it will remain in the gallbladder.
Abdominal pain and cramps are the main symptoms of gallbladder disease. Biliary dyskinesia, which does not involve gallstone formation, is sometimes referred to as acute gallbladder disease. Your doctor will need to perform a comprehensive examination with diagnostic tests to rule out gallstones before treatment can begin.
Diagnostic tests involve blood tests to evaluate liver function and bilirubin levels. An ultrasound can be done to rule out the presence of gallstones. If the patient does not have gallstones, further tests will be needed to make a diagnosis.
In many cases, the patient will be referred for nuclear medicine tests in which a radioactive substance is injected into the bloodstream. This radioactive substance builds up in the gallbladder. The doctor will then be able to monitor the flow of the substance and the rate of secretion from the gallbladder.
Once a patient has been diagnosed with biliary dyskinesia, the most common treatment is gallbladder removal. Removal of the gallbladder is a surgical procedure known as a laparoscopic cholecystectomy. This surgery is performed on an outpatient basis while the patient is under general anesthesia. Most patients will experience normal digestion and a reduction in abdominal pain after this surgery.
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