Biliary dyskinesia is the functional disorder of the gallbladder (cholecyst) that affects its tone and motility. Moreover, biliary dyskinesia is considered to be a symptom of some diseases, such as: hypothyroidism, pancreatitis, diabetes, celiac disease, kidney stones, gastritis, duodenal ulcer, hemolytic anemia, systemic lupus erythematosus (SLE) or fibromyalgia. The latter is characterized by muscle spasms that can also affect the gallbladder muscles. Biliary dyskinesia, “lazy bile”, represents a complex of biliary-type digestive disorders, manifested by:
– pains in the right side of the abdomen below the ribs, pains that can have different intensities, from a simple painful embarrassment to strong colic); bitter taste ; nausea; bilious vomiting; burning in the upper part of the abdomen; lack of appetite; increased irritability; physical or intellectual asthenia; bloating.
Causes of biliary dyskinesia and risk factors
Lazy bile has no known cause, so it is speculated that a possible cause could be an underlying metabolic disorder, such as a hormone or enzyme deficiency, affecting the gastrointestinal tract. Risk factors for biliary dyskinesia include:
– stress, which causes a dysfunction of dopamine receptors, the hormone of pleasure and reward; neurohormonal defects; hormonal imbalances; functional causes; increasing the resistance of the sphincter of Oddi, which controls the flow of bile and pancreatic juice from the pancreas into the small intestine and prevents retention of the contents of the intestine in the pancreatic and bile ducts; obesity; eating certain foods, especially those rich in fat; chronic inflammation.
lDiagnosis of biliary dyskinesia
There are two diagnostic tests for evaluating and diagnosing biliary dyskinesia.
HIDA scan
A hepatobiliary iminodiacetic acid (HIDA) scan may be ordered if the diagnostic criteria for “lazy bile” are met. The HIDA scan is an imaging procedure that involves a radioactive tracer being injected into a vein in the arm and traveling to the liver, where the bile-producing liver cells take up the tracer. This diagnostic method is used to evaluate gallbladder abnormalities when no gallstones are seen on ultrasound.
Upper endoscopy
This is a procedure that is usually performed on an outpatient basis and involves the use of a flexible tube with a camera (inserted through the mouth) to view the upper digestive system. The procedure may be used before gallbladder removal to confirm that the patient’s symptoms are not caused by another condition of the upper gastrointestinal tract, such as stomach or small bowel ulcers, tumors, other structural disorders of the upper digestive tract, or reflux disease gastroesophageal reflux disease (GERD), notes Very Well Health.
Treatment of biliary dyskinesia
In addition to drug treatment, based on analgesics and non-steroidal anti-inflammatories, and which is administered over a well-regulated period, diet is very important in the diagnosis of biliary dyskinesia, Timișoara Military Emergency Hospital (SMUTM) reports. Thus, on the list of prohibited foods are: foods and appetizers with a spicy taste, pepper, mustard, garlic, hot peppers, smoked products, strongly spiced pasta, eggs (especially egg yolk, fried eggs), fats in general, butter, margarine , fatty meats, fatty meat soups, sausages, game, smoked meats, fried fish, fatty fish, clams and seafood, bacon, fried oil, mayonnaise, milk and fatty yogurts, fatty cheeses, cheeses, sauces, curds (sauces with fried flour), meat and fried potatoes, canned food, raw vegetables and vegetables, black radishes (cause strong contractions of the gallbladder), chocolate, sweets with high fat or egg content, nuts, peanuts, pistachios, kiwi and figs, bread very fresh.
According to SMUTM, these are examples of foods with a high risk of triggering biliary symptoms, so it depends on each person how they tolerate them.
Regarding the permissiveness of foods in cholecystitis, they are:
– pasta and rice without sauces with a high fat content; vegetable purees; white meat; lean fish; cottage cheese, yogurt and skimmed milk; toast ; boiled vegetables (beets, carrots, potatoes); raw fresh fruit or in compote, oranges, lemons, apples, cherries, pears; teas (marigold, artichoke); fresh juices.
Smoking is also completely prohibited for patients with biliary dyskinesia.
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