By far, gallstones are the most common gallbladder disease. Gallbladder sludge is sometimes a precursor to gallstones, but it is not a disease. Whether it leads to gallstones or not, sludge indicates something wrong with gallbladder or liver functions.
Gallbladder sludge is much like sounds: A mixture of bile, mucous and tiny bits of cholesterol-based and calcium-based particles. Sometimes, this gelatinous gunk gets stuck in the bile duct. Without sludge, bile naturally passes through the gallbladder from the liver to the duodenum to ultimately help digest fatty foods. However, sludge can just slosh around in the gallbladder causing gallbladder infections and more.
Symptoms
Some people with gallbladder sludge have no symptoms at all and the sludge eventually resolves itself. Sometimes symptoms are vague and non-specific with tenderness or pain in the right or upper abdomen in the general area where the liver and gallbladder are located. For others, excruciating pain can radiate from the right upper quadrant of the abdomen and around the back to the shoulder, with or without nausea and vomiting.
These attacks can occur irregularly, more than a week apart, usually waking the person late at night several hours after eating. Triggers can be very large meals and/or fatty meals. Symptoms are not relieved by getting up or moving around, passing gas or taking over- the-counter pain medications.
Attacks can resolve themselves spontaneously after a few hours. However, they are likely to reoccur and can lead to other problems. A medical evaluation from a licensed practitioner is needed to find the cause and to prevent more serious health issues.
Diagnosis
The first important step to diagnosis is the patient’s own description of symptoms to the doctor. Liver blood tests are then ordered and a fasting ultrasound is done. The ultrasound should be a full abdominal study to rule out other health issues which can have similar symptoms.
Should either or both of those tests show reason for question, there are more steps in diagnosing the cause behind the sludge: One is the Nuclear Medicine Hepatobiliary Scan with Ejection Fraction Screening Tool, or HIDA Scan: Cholestincigraphy. This test is usually done at a local hospital, and it takes a couple hours to complete. This is a fasting test, like the regular abdominal ultrasound.
Other common testing options for diagnosing gall bladder issues and sludge are Magnetic Resonance Imaging (MRI) or Computerized Tomography (CT or CAT scan) Cholangiography, either by insertion through the skin, or endoscopic (ERCP) insertion down the throat. Endoscopic is becoming less common today, according to MedicineNet.com’s overview of gallbladder sludge.
The Bottom Line
Gallbladder sludge can sometimes resolve itself. However, complications can lead to other health issues, including gallstones, pancreatitis, cholecystitis and gallstone-biliary colic.
Ending gallbladder sludge can take several paths. Each has its own risks and benefits that vary from one case to another, and depend upon the underlying cause of the sludge. A gastrointestinal specialist physician should guide a patient to the choice best for the individual situation. Depending upon each patient’s individual situation and doctor recommendation, the options can be watching and waiting to see if the sludge resolves itself, changing eating habits or surgerical removal of the gallbladder.
Sources
www.liverdoctor.com
www.medterms.com
www.medicinenet.com
www.annals.org
www.gastro.org
