Table of ContentsView AllTable of ContentsSymptomsDiagnosisCausesTreatmentWhat to EatComplications
Table of ContentsView All
View All
Table of Contents
Symptoms
Diagnosis
Causes
Treatment
What to Eat
Complications
Gallbladder sludge, or biliary sludge, is a mixture of particles and bile that can build up in the gallbladder. The gallbladder is a small organ that stores and releases bile, a digestive fluid. It is on the right side of the body, under the liver.
Gallbladder sludge may or may not cause symptoms. It may be found when looking for the cause of right-sided back or abdominal pain. It could also be seen when testing for another condition that doesn’t involve the gallbladder (called an incidental finding).
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Does Gallbladder Sludge Always Cause Symptoms?
Biliary sludge or gallbladder sludge does not always cause symptoms. There is not a lot of data on how many people with gallbladder sludge have symptoms. This is partly because it’s not always thought of as a distinct condition that is diagnosed separately fromgallbladder disease.
Some of the general symptoms of a problem with thegallbladder, which may include gallbladder sludge, are:
Without Pain
One study showed that 10% to 15% of people may have symptoms when they have gallbladder sludge.Most people don’t have anygallbladder painand may not know there is any biliary sludge. Symptoms may come and go or stop completely.
Some people may have an inflamed gallbladder or later develop gallstones.Gallstonesare pebble-like lumps of cholesterol or pigments that form in the gallbladder.
With Pain
When abdominal pain is present, there is a 50% chance that the sludge will clear up on its own. In 20% of people, the sludge may be present but cause no symptoms.
About 10% to 15% of people with abdominal pain who have gallbladder sludge go on to have symptoms of gallbladder disease. The other 5% to 15% will experience progressive disease and the formation of gallstones.
Gallbladder Sludge on Ultrasound
Gallbladder sludge may be seen during an ultrasound. Usually, anultrasoundwould be used when there are symptoms, and it’s suspected that the gallbladder is the cause.
An ultrasound uses sound waves to see the structures and organs inside the body. When there’s a reason to look at the gallbladder, the test used is called a transabdominal ultrasound. Gallbladder sludge bounces the sound waves back, so it is seen during this test.
If sludge is seen but there doesn’t appear to be any gallstones, another test may be done. Some gallbladder sludge may be removed during anendoscopic retrograde cholangiopancreatography (ERCP)and examined in a lab to determine the contents of the sludge, such as small solid particles or crystals.
Another test that might be used is endoscopic ultrasonography (EUS). An EUS combines endoscopy and ultrasound. A thin tube is passed into the mouth and down through the digestive tract. Special tools and a camera on the end can be used to look at the structures in the body and obtain some fluid from inside the gallbladder.
Formation From Bile
When bile stays in the gallbladder for longer than it should, it can become stagnant. It begins to form particles that turn into sludge. The contents of gallbladder sludge can vary based on the cause.
Sludge in the gallbladder could contain:
Some of the causes and risk factors for gallbladder sludge are similar to those of gallstones, such as:
There are several reasons why people may be more likely to develop gallbladder disease or sludge.
Nonhereditary reasons for the development of gallbladder problems include:
Some of the acute and chronic conditions that can cause gallbladder problems are:
People of certain ages, sexes, and ethnicities are more likely to be diagnosed with gallbladder disease. These groups include:
A Note on Gender and Sex TerminologyVerywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To reflect our sources accurately, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.
A Note on Gender and Sex Terminology
Verywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To reflect our sources accurately, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.
Some people may also have a genetic factor that makes them more likely to have gallbladder disease. Several genes, called lithogenic (LITH)genes, may make a person more likely to develop gallbladder stones or disease. The LITH genes affect the creation and transport of cholesterol and bile acids.
Certain variants of LITH genes may make a person more likely to have gallstones that have symptoms. It’s estimated that 25 to 30% of symptomatic gallstones may be associated with variants in LITH genes.
If sludge is seen or suspected, a sample of it may need to be obtained. This could be done during an ERCP or an EUS, especially when there are symptoms in the upper digestive system. A healthcare provider will not want to use too many invasive tests unless there is a compelling reason.
For some people, a watch-and-wait approach (a period of observation in which no treatment is given) might be used for gallbladder sludge. This is especially true if there aren’t any symptoms, but the sludge was found incidentally (while looking for a different issue).
People who have documented gallbladder sludge may be candidates for treatment with Actigall (ursodeoxycholic acid). This treatment is a medication that can help with sludge, but it isn’t recommended if someone has actual gallstones.
Removal of the gallbladder (cholecystectomy) may be recommended, especially for people who are having symptoms. This treatment would be curative because without the gallbladder, sludge can no longer form in it.
There is little evidence thatalternative and complementary methodscan help clear the gallbladder of sludge or prevent gallstones.
To manage gallbladder sludge, your healthcare provider may recommend somechanges to your diet. In general, a healthful diet that prioritizes fruit and vegetables and includes less fat and sugar will be recommended.
These tips may be helpful when considering a diet to support gallbladder health include:
It’s also worth noting that rapid weight loss may also be associated with a risk of gallbladder disease. Having weight loss surgery or following a diet that is very low in calories may put people at risk for gallstones. Therefore, working with a healthcare provider on changing your diet is important, especially when you are losing weight quickly.
Some observational studies show that drinking coffee may be associated with a lower incidence of gallbladder problems.
Monitoring Related Complications and Conditions
Gallbladder sludge may progress togallbladder diseaseorgallstones. A healthcare provider can assess whether monitoring or treatment is needed.
When sludge formation is due to an event such as pregnancy or rapid weight loss, it may resolve when the event is over, and symptoms may resolve naturally.
However, in some cases, sludge is associated with complications, such as the formation of gallstones. There’s also a potential to developbiliary colic. This is when a bile duct becomes obstructed, causing pain and other symptoms.
When gallstones form, they can lead to a host of other problems.Gallstones can be removedwith an ERCP, broken up into smaller pieces, or the gallbladder can be surgically removed.Gallstones may cause pain and complications without treatment.
However, much is still not known about gallbladder sludge and how it may affect overall health. Some of the data on this condition are from people who are living with other conditions or even gallstones, so it is challenging to know how it will affect people without complicated medical histories.
Abdominal or Radiating PainGallbladder pain can be acute (sudden), or it can come and go over a few days. It may also go away only to return after eating a fatty meal.People diagnosed with a gallbladder condition will want to stick to a diet that doesn’t cause symptoms. With or without an established diagnosis, New or worsening pain is a reason to see a healthcare provider as soon as possible.
Abdominal or Radiating Pain
Gallbladder pain can be acute (sudden), or it can come and go over a few days. It may also go away only to return after eating a fatty meal.People diagnosed with a gallbladder condition will want to stick to a diet that doesn’t cause symptoms. With or without an established diagnosis, New or worsening pain is a reason to see a healthcare provider as soon as possible.
Summary
Gallbladder sludge can occur with or without symptoms. Most people will not know that they have gallbladder sludge or have any symptoms. Sludge in the gallbladder could lead to developing stones in the gallbladder.
There is usually no treatment prescribed when sludge is found without any other risks, but gallbladder removal may be used if there is a progression to complications.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Johns Hopkins Medicine.Gallbladder disease.Wang HH, Portincasa P, Liu M, Tso P, Wang DQ.Similarities and differences between biliary sludge and microlithiasis: their clinical and pathophysiological significances.Liver Res.2018;2:186-199. doi:10.1016/j.livres.2018.10.001National Institute of Diabetes and Digestive and Kidney Diseases.Gallstones.Di Ciaula A, Wang DQ, Portincasa P.An update on the pathogenesis of cholesterol gallstone disease.Curr Opin Gastroenterol. 2018;34:71-80. doi:10.1097/MOG.0000000000000423Gutt C, Schläfer S, Lammert F.The treatment of gallstone disease.Dtsch Arztebl Int. 2020;117:148-158. doi:10.3238/arztebl.2020.0148Wirth J, Song M, Fung TT, et al.Diet-quality scores and the risk of symptomatic gallstone disease: a prospective cohort study of male US health professionals.Int J Epidemiol. 2018;47:1938-1946. doi:10.1093/ije/dyy210Larsson SC, Giovannucci EL, Wolk A.Coffee consumption and risk of gallbladder cancer in a prospective study.J Natl Cancer Inst. 2017;109:1-3. doi:10.1093/jnci/djw237.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Johns Hopkins Medicine.Gallbladder disease.Wang HH, Portincasa P, Liu M, Tso P, Wang DQ.Similarities and differences between biliary sludge and microlithiasis: their clinical and pathophysiological significances.Liver Res.2018;2:186-199. doi:10.1016/j.livres.2018.10.001National Institute of Diabetes and Digestive and Kidney Diseases.Gallstones.Di Ciaula A, Wang DQ, Portincasa P.An update on the pathogenesis of cholesterol gallstone disease.Curr Opin Gastroenterol. 2018;34:71-80. doi:10.1097/MOG.0000000000000423Gutt C, Schläfer S, Lammert F.The treatment of gallstone disease.Dtsch Arztebl Int. 2020;117:148-158. doi:10.3238/arztebl.2020.0148Wirth J, Song M, Fung TT, et al.Diet-quality scores and the risk of symptomatic gallstone disease: a prospective cohort study of male US health professionals.Int J Epidemiol. 2018;47:1938-1946. doi:10.1093/ije/dyy210Larsson SC, Giovannucci EL, Wolk A.Coffee consumption and risk of gallbladder cancer in a prospective study.J Natl Cancer Inst. 2017;109:1-3. doi:10.1093/jnci/djw237.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Johns Hopkins Medicine.Gallbladder disease.Wang HH, Portincasa P, Liu M, Tso P, Wang DQ.Similarities and differences between biliary sludge and microlithiasis: their clinical and pathophysiological significances.Liver Res.2018;2:186-199. doi:10.1016/j.livres.2018.10.001National Institute of Diabetes and Digestive and Kidney Diseases.Gallstones.Di Ciaula A, Wang DQ, Portincasa P.An update on the pathogenesis of cholesterol gallstone disease.Curr Opin Gastroenterol. 2018;34:71-80. doi:10.1097/MOG.0000000000000423Gutt C, Schläfer S, Lammert F.The treatment of gallstone disease.Dtsch Arztebl Int. 2020;117:148-158. doi:10.3238/arztebl.2020.0148Wirth J, Song M, Fung TT, et al.Diet-quality scores and the risk of symptomatic gallstone disease: a prospective cohort study of male US health professionals.Int J Epidemiol. 2018;47:1938-1946. doi:10.1093/ije/dyy210Larsson SC, Giovannucci EL, Wolk A.Coffee consumption and risk of gallbladder cancer in a prospective study.J Natl Cancer Inst. 2017;109:1-3. doi:10.1093/jnci/djw237.
Johns Hopkins Medicine.Gallbladder disease.
Wang HH, Portincasa P, Liu M, Tso P, Wang DQ.Similarities and differences between biliary sludge and microlithiasis: their clinical and pathophysiological significances.Liver Res.2018;2:186-199. doi:10.1016/j.livres.2018.10.001
National Institute of Diabetes and Digestive and Kidney Diseases.Gallstones.
Di Ciaula A, Wang DQ, Portincasa P.An update on the pathogenesis of cholesterol gallstone disease.Curr Opin Gastroenterol. 2018;34:71-80. doi:10.1097/MOG.0000000000000423
Gutt C, Schläfer S, Lammert F.The treatment of gallstone disease.Dtsch Arztebl Int. 2020;117:148-158. doi:10.3238/arztebl.2020.0148
Wirth J, Song M, Fung TT, et al.Diet-quality scores and the risk of symptomatic gallstone disease: a prospective cohort study of male US health professionals.Int J Epidemiol. 2018;47:1938-1946. doi:10.1093/ije/dyy210
Larsson SC, Giovannucci EL, Wolk A.Coffee consumption and risk of gallbladder cancer in a prospective study.J Natl Cancer Inst. 2017;109:1-3. doi:10.1093/jnci/djw237.
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