Though gallstones are the most common problem involving the gallbladder, the gallbladder can also function poorly in the absence of stones. The term given to this condition is biliary dyskinesia.
The symptoms of biliary dyskinesia are frequently identical to those caused by gallstones. Patients often have pain or nausea after eating. Unfortunately, when gallstones are not found, physicians often look for other causes of abdominal pain, rather than considering whether the gallbladder is functioning properly. Delays in diagnosis are common with biliary dyskinesia.
A HIDA scan is a gallbladder test that helps detect biliary dyskinesia, essentially measuring how well the gallbladder is working. It also attempts to reproduce the patient's symptoms by stimulating gallbladder contraction. Though a HIDA scan is helpful when it confirms biliary dyskinesia, a normal study does not rule out biliary dyskinesia.
When studies suggest the gallbladder is not working, or their is a high level of clinical suspicion biliary dyskinesia is present, laparoscopic gallbladder surgery is frequently offered. In such situations, up to 90% of patients may see significant improvement in symptoms.