Sometimes the bile causes discomfort without the presence of gallstones or inflammation of the gallbladder. Doctors then speak of biliary dyskinesia.
What is biliary dyskinesia?
The term biliary dyskinesia stands for symptoms that are not caused by gallstones or gallbladder inflammation, but are caused by irritation of the gallbladder. The proverbs “I get bile up” or “Spit poison and bile” aptly describe a gall bladder. In many cases, the symptoms are related to a reduced flow of bile without an organic disease being found.
Medicine therefore speaks of functional complaints such as irritable stomach or irritable bowel syndrome. The technical term “dyskinesia” comes from the Greek and stands for incorrect movements, which show the main problem of these complaints. The biliary tract and gallbladder are surrounded by muscles that usually contract and relax again. In biliary dyskinesia, these muscles can become cramped and interfere with the functioning of the gallbladder and biliary tract.
Causes
In most cases, biliary dyskinesia is caused by psychosomatic symptoms such as anger and stress. This leads to a cramping of the gallbladder and the biliary tract and a functional impairment that causes the irritable gallbladder.
Normally, the muscles of the biliary tract contract rhythmically and then relax. In this way, the transfer of the bile into the intestine is ensured. In addition to psychological stress, food intolerance can also disrupt this mechanism.
However, biliary dyskinesia can also hide organic biliary problems that are difficult to diagnose. Very small bile semolina or barely detectable gallstones can cause symptoms in sensitive people, but they can be difficult to diagnose. Gallbladder inflammation, which is difficult to spot, can also be a cause. In addition, other diseases such as irritable stomach, irritable bowel syndrome, stomach ulcers, reflux or similar complaints such as irritable gallbladder can cause.
Symptoms, ailments & signs
An irritable gallbladder causes symptoms similar to organic gallbladder problems. The biliary congestion usually causes pain under the right costal arch, which occurs permanently or temporarily and can radiate into the shoulder. Painful colic can also occur with an irritable gallbladder. Often the symptoms occur after lavish and high-fat meals, coffee or alcohol consumption.
The intolerances are expressed in a feeling of fullness, flatulence and diarrhea. The lack of bile can lead to greasy bowel movements. The symptoms are very similar to those of gallstones. The symptoms can be mild, but they can also be severe and cramp-like and last from a few minutes to several hours. In contrast to gallbladder inflammation, the skin does not turn yellow and the stool is not discolored either.
Diagnosis
In the case of unclear biliary symptoms, a doctor should always be consulted to clarify the cause of the symptoms. For the diagnosis, it is first important to rule out other diseases. By taking a detailed anamnesis, the doctor can determine whether there has been a history of biliary tract disease.
He can get an idea of eating habits and assess risk factors such as tobacco and alcohol consumption, possible side effects of medication, allergies and exposure to stress and anger. This is followed by a physical examination in which the abdomen is scanned in order to detect possible hardening, which can provide an indication of illness. A blood test in the laboratory can reveal a possible inflammation of the gallbladder or other diseases.
The best way to detect gallstones or inflammation of the gallbladder is an ultrasound scan. If these tests do not provide a clear diagnosis, a contrast x-ray or computed tomography may be done.
Complications
The biliary dyskinesia leads to relatively severe symptoms in the liver. The pain occurs as a result of the so-called biliary congestion and can also lead to vomiting and loss of appetite. Patients also suffer from pain after consuming fatty or very sweet meals, although alcohol and coffee also have a negative effect on biliary dyskinesia.
It is not uncommon for gas and bloating to occur, so that the patient’s quality of life is greatly reduced. The pain can go away relatively quickly or last for a longer period of time. As a rule, biliary dyskinesia can be well diagnosed so that early treatment is possible. This is often done by changing the diet to healthy foods and by avoiding alcohol, cigarettes and coffee.
By adopting a healthy lifestyle, biliary dyskinesia can be severely restricted so that there are no further complications and complaints. As a rule, obesity must always be reduced. Life expectancy is not affected if the patient’s lifestyle changes. However, if the lifestyle remains unchanged, it can lead to inflammation of the pancreas.
When should you go to the doctor?
A doctor should be consulted as soon as physical impairments and stress arise due to a stressful life situation. If the stress in everyday life cannot be reduced or averted independently, there is the possibility that a doctor will provide the necessary assistance.
If the general performance decreases, if sleep disturbances occur or if fatigue sets in, a visit to a doctor is advisable. If the person concerned complains of chest pain, persistent internal restlessness, or if they are severely irritable, the information should be discussed with a doctor.
In the event of symptoms such as diarrhea, constipation, gas or a feeling of fullness, a doctor’s visit is necessary. If the symptoms persist for a long time or if they intensify, a doctor should be consulted to clarify the symptoms. In the case of fatty stools or recurring abdominal pain, it is advisable to see a doctor for a check-up.
If the person concerned suffers from a deterioration in their usual quality of life, a general feeling of illness or severe changes in their own weight, they should consult a doctor. Loss of appetite is considered unusual if it persists for several days or weeks. It is therefore advisable to consult a doctor if the person concerned notices that they are suffering from weakness, a lack of energy or indifference due to a change in food intake.
Treatment & Therapy
The therapy depends on the diagnostic findings. Since in most cases the symptoms are functional, therapy consists mainly of symptom relief. If no organic causes are found, the doctor can carefully motivate the patient to seek psychotherapeutic help. It often helps to change your lifestyle in such a way that any stress can be better managed.
Relaxation procedures and wellness treatments help to relax the vegetative nervous system. In abdominal cramps, the good old hot water bottle has always proven. If lavish and high-fat meals are not tolerated, the amount of food should be restricted and the fat content reduced in order to relieve the bile. Being overweight can put pressure on the abdomen, so symptoms can improve if the overweight is reduced.
Spices such as turmeric, ginger and curry have a stimulating effect on the flow of bile and can be a valuable measure in food preparation. Fresh herbs such as dandelion, nettle, sorrel and yarrow also support the flow of bile.
Alcohol should be avoided if you have biliary problems. Anti-spasmodic drugs such as Buscopan help against severe symptoms of biliary dyskinesia, and metamizole for severe pain. Surgical transection of the spinkter-Oddi muscle is rarely performed as part of an ERCP because it increases the risk of pancreatitis.
Outlook & forecast
The prognosis of biliary dyskinesia is favorable when using medical care and actively cooperating with the patient to alleviate the symptoms. With a change in current lifestyle, many people affected can already experience a significant improvement in their health.
The focus is on optimizing food intake and reducing existing stressors. These are designed individually and must therefore be assessed and processed by each patient according to their own specifications. The use of psychotherapeutic approaches is also helpful. For most of those affected, the healing process takes place over several months or years. This is linked to the patient’s insight and cooperation. In some cases, relief or complete freedom from symptoms may already occur.
For a good prognosis, it is necessary to refrain from consuming harmful substances such as alcohol, drugs or nicotine. Misuse of medication should also be ruled out. The general lifestyle and the structuring of everyday life can have a positive effect on recovery. Good sleep hygiene, restful sleep and physical needs must be taken into account.
For many patients, cognitive changes and environmental restructuring may be necessary. Better success is achieved with those affected who, in addition to the treatment plan, also deal with relaxation methods and use natural remedies to help.
Prevention
Since the causes of functional complaints are mainly in the emotional area, sufficient times for relaxation, good stress management and a balanced lifestyle with a healthy diet are good prevention. The diet for gallbladder problems should not be too fatty. Alcohol and coffee should only be consumed in moderation by sensitive people so as not to unnecessarily irritate the bile.
Aftercare
The options for follow-up care are only possible to a very limited extent in the case of biliary dyskinesia. First and foremost, this disease needs to be properly treated by a doctor to prevent further complications and discomfort. Further complaints can only be avoided through correct and, above all, early diagnosis and treatment of this disease.
With biliary dyskinesia, those affected are primarily dependent on relaxation. Sensitive conversations with friends or family can also be very helpful to alleviate the symptoms. In many cases, contact with other sufferers of biliary dyskinesia can also be useful, as this leads to an exchange of information that can make everyday life easier.
Ginger or dandelion can also help relax the body and relieve cramps. Since biliary dyskinesia can also lead to inflammation of the pancreas, regular examinations of the body should be done to prevent this inflammation. It cannot generally be predicted whether the life expectancy of the person affected will be reduced by this disease. Often the patients are also dependent on psychological support.
You can do that yourself
If biliary dyskinesia has been unequivocally diagnosed by a specialist, there are various treatment options available. These depend on the severity of the disease. Regardless of which option the patient chooses, therapy should always be discussed with the attending physician.
In severe cases, surgery is necessary. Until the operation, the patient can make everyday life easier by following the dietary recommendations of the doctor. Avoiding fatty foods prevents further deterioration in health. Regular light exercise and avoidance of stress can help improve your overall physical condition. In this way, the patient can go into the operation in good general condition and, ideally, will recover from it more quickly.
In milder cases, surgery is not necessary. The patient should not decide this for himself, but should follow the advice of his doctor. If the typical complaints only occur from time to time, the patient can analyze his eating behavior more precisely.
A food diary provides a very good basis for your own observations and for later discussions with the doctor. Fatty foods should be avoided completely. Also, a nutrition counseling can help the patient to find out the right foods. On alcohol and nicotine and other substances that burden the body, should be avoided.
