Treatment of Biliary Dyskinesia

Before the start of the treatment it is important to diagnose the type of gallbladder dyskinesia that the patient has. Depending on whether the patient has hyperkinetic or hypokinetic gallbladder dyskinesia, the treatment will be different.

General recommendations.

A good way to prevent biliary dyskinesia is to have at least 4 meals per day at the same time each day. Meals shouldn’t be too large and have a sufficient amount of protein, nutrients, and fiber.

Avoid physical and mental exhaustion as it can trigger biliary dyskinesia.

Hyperkinetic form of gallbladder dyskinesia

• Diet
  The patient should have at least 4-5 meals per day

  Food that causes contraction of the gallbladder should be avoided. This includes fatty products, meat, vegetable oil, pancakes, doughnuts and other similar bakery products, beer, and soft drinks.

  The majority of food should be either steamed or boiled without adding too much oil or spices.

  The diet should include a plentiful amount of fruits and berries.

• Drug treatment

  Spasmolytics (antispasmodics) – these drugs relax the smooth muscles which helps prevent and treat muscle spasms of the biliary system, cystic sphincter, and the sphincter of Oddi. Spasmolytics allow for the bile to flow freely from gallbladder into duodenum. However, if the person has gastroesophageal reflux disease, antispasmodics can worsen the symptoms of this disease.

  Choleretics – substances which stimulate the secretion of bile, preventing it from inspissating (when the bile is concentrated in the gallbladder as the liquid part of it is getting reabsorbed back into the gallbladder) which can possibly lead to the formation of gallstones.

  Mineral waters – an ancient method that has been used for centuries is still recommended today. Lightly mineralized water should be heated to 25-40 degrees Celsius and taken 3-4 times per day half an hour before a meal.

Diet for hypokinetic form of gallbladder dyskinesia

This diet should always include products that have a choleretic effect, which includes sour cream, butter and vegetable oil, cream, soft-boiled eggs, dark bread, vegetables. These products stimulate the function of the gallbladder and the bile ducts.

Aloe extract and ginseng can also be used for the same purpose.

Special herbal teas with choleretic effect can also be used.

Mineral waters with high levels of mineralization can be used. They should be taken cold, 30-60 minutes before eating a meal, 3-4 times per day.

Surgical treatment

Gallbladder dyskinesia is treated using laparoscopic cholecystectomy. During the procedure 3 or 4 small holes are made in the abdominal wall and the gallbladder is removed using laparoscope. The procedure is relatively safe and in 90% of the cases relieves the patient of all symptoms.

Motility disorder of the sphincter of Oddi – when this condition is diagnosed using sphincter of Oddi manometry, a sphincterotomy should be performed. During the procedure an incision is made in the sphincter of Oddi, making it easier for the bile and for pancreatic juices to pass through it. This operation results in long-term relief for over 80% of the patients with this condition.

Prognosis

Most people with hyperkinetic form of gallbladder dyskinesia outgrow it with no traces of the disease left in the adulthood. Hypokinetic form of gallbladder dyskinesia, however, should be treated using cholecystectomy. Removing the gallbladder removes all the symptoms in 90% of the patients. The rest might also need to go through sphincterotomy as they might have motility disorder of the sphincter of Oddi.