What Is an Overactive Gallbladder?
An overactive gallbladder, medically termed hyperkinetic gallbladder or biliary dyskinesia, is a functional disorder where the gallbladder contracts too much or too forcefully. This excessive contraction leads to symptoms without the presence of gallstones or inflammation typically seen in other gallbladder conditions. This condition signifies a functional abnormality in the gallbladder’s activity rather than a physical obstruction.
Understanding Gallbladder Function
The gallbladder normally functions as a small organ responsible for storing and concentrating bile, a digestive fluid produced by the liver. When fatty foods are consumed, the gallbladder receives signals to contract and release this concentrated bile into the small intestine, aiding in the digestion and absorption of fats. In an overactive gallbladder, this contraction becomes excessive, causing discomfort and pain. The precise reason for this overactivity is not always clear, but it stems from an issue with the organ’s functional movement.
Recognizing the Symptoms
Individuals with an overactive gallbladder commonly experience sharp pain located in the upper right abdomen. This discomfort can sometimes spread to the back or the right shoulder blade. The pain frequently arises after eating, especially following meals high in fat, as this stimulates the gallbladder to contract. Other associated symptoms may include nausea, vomiting, a feeling of bloating, and general indigestion or abdominal discomfort. These symptoms can be non-specific, however, and may resemble those of other digestive problems, which sometimes makes diagnosis challenging.
Diagnosing Overactive Gallbladder
Healthcare professionals primarily diagnose an overactive gallbladder using a hepatobiliary iminodiacetic acid (HIDA) scan with cholecystokinin (CCK) stimulation. A HIDA scan is a nuclear medicine test that tracks the flow of bile from the liver through the bile ducts and into the small intestine. During the test, a small amount of a radioactive tracer is injected, which is absorbed by the liver and excreted into the bile. Subsequently, CCK is administered to stimulate the gallbladder’s contraction, allowing for the measurement of its emptying efficiency.
The key diagnostic indicator from this test is the gallbladder ejection fraction (EF). An abnormally high ejection fraction, typically above 80%, can indicate an overactive gallbladder. Before reaching a diagnosis of hyperkinetic gallbladder, other conditions, such as gallstones or inflammation, must be ruled out, often through an abdominal ultrasound. This comprehensive approach ensures that the symptoms are indeed due to an overactive gallbladder and not another underlying issue.
Treatment Options
Managing an overactive gallbladder often begins with conservative measures, focusing on dietary adjustments. Adopting a low-fat diet can help reduce the frequency and intensity of gallbladder contractions. Eating smaller, more frequent meals may also help minimize the stimulation of the gallbladder. While some medications, such as antispasmodics, have been explored, they are generally not considered highly effective for directly treating this condition.
For individuals experiencing persistent and bothersome symptoms despite dietary changes, surgical removal of the gallbladder, known as cholecystectomy, is often the definitive treatment. Most cholecystectomies are performed laparoscopically, a minimally invasive technique involving small incisions, which typically results in a quicker recovery compared to traditional open surgery. Patients can often return home the same day as the procedure, with a recovery period that allows for a gradual return to normal activities. Studies indicate that a significant percentage of patients experience symptom improvement after cholecystectomy for hyperkinetic gallbladder.