Diagnosed with gall bladder dyskenesia

[andy50805]

Hi,

I was recently diagnosed with gallbladder dyskinesia. My HIDA exam showed an ejection fraction of 13% at 30 minutes. Since I don’t have gallstones, and only mild discomfort, surgery wasn’t recommended at this time. My symptoms are bloating and gas after eating, and a pinching or dull pain in my upper right abdominal area which I seem to feel more when I’m stressed than after eating a meal.

I have lots of question which I can’t seem to find clear answers to online.  I know it’s a long list, but any help would be much appreciated.

- Why do I feel URQ discomfort more when stressed than after a meal? Could there be something else going on?
- Am I better off with a gallbladder working at 15% or with no gallbladder?
- What effect does the slow gallbladder have on my liver? Does it make less bile?
- Is it possible to regain lost gallbladder function?
- Is there anything I can do, besides eliminating fats, to improve functioning?
- Can digestive enzymes (plant based) helpful in relieving gas and bloating?

Thank you!

[Christopher R Watters, MD]

A completely empty gallbladder would be very unusual. Dynamic studies have indicated that the gallbladder doesn't simply contract on demand but is constantly contracting and relaxing similar to a bellows.

[andy50805]

Thanks for the response. I’m mostly trying to understand what the discomfort is that I’m feeling and if it is in fact my gall bladder. My understanding was that a healthy gall bladder empties itself after eating. Since mine empties so slowly, I assumed that the fullness of it might be causing some of the discomfort (although I often feel the discomfort long after eating.)

I think my confusion is in the mechanics of the liver and gallbladder. I thought that eating less fat would reduce the amount of bile produced and stored in the gall bladder and therefore reduce the discomfort. From your response, I understand that the consumption of fat only causes the gall bladder to excrete the bile, but then the liver just replaces the bile that was excreted back into the gall bladder (??). Does this mean that the gall bladder always contains bile, even a healthy one?  Maybe there’s a “gallbladder for dummies” article somewhere that you can direct me to.

[Christopher R Watters, MD]

There are several factors that can affect the measured ejection fraction of the gallbladder. One has to use the test in context with the clinical history. I am not sure why one would even get the study if the symptoms were minor and would not justify surgery. The HIDA is not meant to be a screening test as the reproducibility is not that great - too many variables in the study.
I'm not sure why you think that eliminating fat would improve function. Fat is the main inducer of CCK release in your body. Eliminating fat merely reduces the signal for the gallbladder to contract. It wouldn't improve it's function. Reduced gallbladder contractility has no direct effect on bile production.