Biliary Dyskinesia: Poor Gallbladder Function Without Stones

February 10, 2026

Biliary Dyskinesia: Poor Gallbladder Function Without Stones

Verified By
KIMS-SUNSHINE
Specialist,
10 February, 2026

Biliary Dyskinesia: Poor Gallbladder Function Without Stones

Biliary dyskinesia is a condition where the functionality of the gall bladder gets compromised- it normally stores bile in it and releases it into the intestine for digestion of fats to occur. But, when bile is not able to move out of the bile ducts from the gallbladder, it can cause symptoms like having a gallstone. There is no structural issue with the gallbladder but it does not work normally. When you have symptoms like constant upper abdominal pain or are not able to enjoy foods like before, you should consult a gastroenterologist at the best hospital in Hyderabad.

Causes for Biliary Dyskinesia

The main cause for biliary dyskinesia is the inability of the gallbladder to contract and release bile into the bile ducts, during digestion. There is no specific cause that is associated with this condition, but researchers think it may be due to some issue with how information travels to and from the vagus nerve. Since the structure of the gallbladder remains unaffected, biliary dyskinesia is considered a functional gallbladder disorder.

Symptoms of Biliary Dyskinesia

Symptoms that you may have to deal with on a regular basis include-

Right upper abdomen pain after meals which is episodic in nature. The pain tends to peak and wane.
You may feel pretty nauseous after a heavy or fatty meal.
Bloating and indigestion are common too.
Weight loss may occur- as you begin to eat less than before.

So, the main takeaway with this condition is gallbladder pain without stones. Nausea after fatty foods is very common too. Other symptoms include headaches, acid reflux which is chronic, IBS, anxiety, depression or extreme fatigue too.

Diagnosis of Biliary Dyskinesia

First, doctors ask you for a detailed list of symptoms- like upper abdomen pain on the right that lasts for at least half an hour, is moderate or severe, does not get better with changes in position or with antacids and if you have had symptoms for the last 3 months or so.

Next stage – here, they check for enzymatic activity- liver enzymes and pancreatic enzyme levels can be ascertained using blood tests.
Imaging- an abdominal ultrasound is done to check if there are any structural abnormalities like gallstones, bile duct dilation or thickening of the gallbladder wall, which can interfere with its ability to contract. If this is normal, then more tests are done.

Last is to check for functioning of the gallbladder- using a HIDA scan- hepatobiliary iminodiacetic acid scan where a radioactive tracer is injected into a vein in your arm, after which imaging with a computer can be used to check how the dye is moving in the hepatobiliary system.

Cholecystokinin is a hormone that tells the gallbladder to contract and release bile when needed. So, after cholesystokinin is injected into the vein, the gallbladder ejection fraction or how quickly contraction occurs is measured with imaging. If this ejection fraction is less than 40% and no other causes have been found to explain your symptoms, you will be diagnosed with biliary dyskinesia.

Highly specialised endoscopy may also be recommended to check if the sphincter at the intestine, which controls bile flow from the ducts to the gut is imaged. This test is normally done only when people who have had their gallbladder removed before still complain of pain and related symptoms.

Treatment for Biliary Dyskinesia

The best treatment which works in most cases is a cholecystectomy or laparoscopic gallbladder removal. Here, since the gallbladder is removed, the bile ducts are directly connected to the small intestine, so bile can continue digestion of fats in foods. Laparoscopic surgeries are minimally invasive and you will recover sooner, while having minimal scarring from the incisions.

Conclusion

You will need to manage your health by cutting down on fatty foods in the long term and introducing more fibre rich foods in your diet. This can also help with reducing bloating or gas. Gallbladder removal normally helps over 90% of biliary dyskinesia cases, but if symptoms still persist, you will need to get in touch with an experienced gastroenterologist at the best multispecialty hospital in Hyderabad- KIMS Sunshine. So, call us today for a consultation!

Frequently Asked Questions

What is biliary dyskinesia?

Biliary dyskinesia is a functional disorder of the gallbladder in which it does not empty bile properly. There are no gallstones or visible blockage, but the gallbladder fails to contract in a coordinated way, causing pain similar to gallstone disease.

What are the symptoms of biliary dyskinesia?

Symptoms include recurrent pain in the upper right abdomen, often after eating. The pain may spread to the back or right shoulder and can last from 30 minutes to several hours. Nausea, vomiting, bloating and intolerance to fatty foods are also reported. Blood tests and ultrasound scans are often normal.

What is a HIDA scan?

A HIDA scan (hepatobiliary iminodiacetic acid scan) is a nuclear medicine test used to assess gallbladder function. A small amount of radioactive tracer is injected into a vein, and a camera tracks how bile flows through the liver, gallbladder and small intestine. The test measures the gallbladder ejection fraction, which shows how well the gallbladder empties.

Is surgery required for biliary dyskinesia?

Treatment depends on symptom severity and scan results. If the HIDA scan shows a low ejection fraction and symptoms are consistent, removal of the gallbladder (cholecystectomy) may be recommended. Surgery can relieve symptoms in many patients, though outcomes vary.

Who is at risk of gallbladder dysfunction?

Risk factors include being female, obesity, rapid weight loss, pregnancy and hormonal changes. It is more common in younger adults and people with a history of digestive disorders.