sludge, glue like bile

I am a 53 yr old male. I have a very good, well balance diet (my wife is a nutritinist and very much into healthy foods). I am 15-20 pounds over my ideal weight and have a very good healthy appetite. Also, I do get a reasonable amount of exersise each week.

I have been a heavy drinker all of my adult life but other than that lead a healthy lifestyle. I had all of the symptoms of gallstones with the very painful attacks upon consumption of fatty foods. My doctor ran all of the normal tests and my liver, pancreas enzyme levels have all been normal. I also had a liver scan where dye was injected and followed through the process of my liver, bile ducts and gallbladder. It was determined that I had a non fuctioning gallblader (gallbladder). I had it removed laproscopicly 8 years ago  and I did not have any gall stones but the gallblader (gallbladder) contained what was described to me as thick, sludgey bile.

Since then I have still had very occasional attacks with the same symptoms as I ahd previous to removal of my gallblader (gallbladder). I have my annual physical exams with liver/pancreas enzynes being checked and the results always come back as normal. I should add that my overall cholesterol level has been high for many years with high HDL keeping the risk factor in the normal range. I have been on statins, but never take them on days when I will consume alcohol.

Last week I had a bad gall bladder like attack after a meal which was very rich. It lasted for a full 24 hrs before I went to emergency at my local hospital.  Liver/pancreas enzyme levels were fine and I had a full ultrasound as well. Kidney, pancres,spleen, liver, bile ducts all looked fine. What was found was that the main bile duct contained bile that was thick and glue like. I was told to increase my liquid intake to hydrate my liver and complete body better.

Quetions
1) Are you familiar with bile that is thick and glue like and does not flow through the duct smoothly?  What causes this?
Can it harm the liver?

2) Can alcohol cause this problem?

3) I was prescrbed Buscopan to help alleviate this. Should this be taken long term or only short term?

4) Could this be fatty liver or cirosis? The utlra sound and blood tests indicated a healthy liver.

5) Can high cholesterol be a factor in this?

[Kevin Pho, MD]

To anwer your questions:
1) The can be variations in bile consistency from patient to patient.  Whether this is harming the liver can be evaluated with liver function tests obtained via the blood.

2) I am not aware of alcohol being linked to the problem of bile sludge.

3) Buscopan is an anti-spasmodic medication, typically used for the treatment of irritable bowel disease.  I am not aware that it can help any liver or gallbladder problem.  Discussion of whether it should be taken long or short term should be discussed with your personal physician.

4) If the ultrasound is negative, it is unlikely that a fatty liver or cirrhosis is present.

5) It is possible that high cholesterol can affect the biliary sludge.

At this time, you can consider an MRCP to further evaluate the biliary tree and to rule out any stone that may be causing your symptoms.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
http://www.straightfromthedoc.com