Investigation and management in Brisbane
Biliary dyskinesia is a functional gallbladder disorder that causes chronic right-upper abdominal pain and digestive discomfort despite the absence of gallstones. The problem is not stones or infection but how the gallbladder contracts and empties bile.
Gallbladder-type pain can occur even when an ultrasound shows no stones. Dr Goutham reviews your symptoms, previous tests and other possible causes of upper-abdominal pain. A HIDA scan may help assess gallbladder function when the findings suggest it would be useful.
Symptoms of biliary dyskinesia
The symptoms closely mimic gallstone disease, which is why specialist assessment matters. They include:
- Recurrent pain in the upper-right abdomen, often after meals
- Pain that may radiate to the back or right shoulder blade
- Nausea, bloating and indigestion, especially after fatty foods
- Episodes lasting from 30 minutes to several hours
- A normal abdominal ultrasound despite ongoing symptoms
Causes and risk factors
Problems with gallbladder emptying may contribute to biliary dyskinesia, although the underlying cause is often unclear. Other conditions can cause similar pain. Dr Goutham considers your symptoms and test results together, including whether gallstones or another structural problem could explain them.
When to see a specialist
Your GP may refer you for assessment when you have persistent right-upper abdominal pain without an obvious cause on ultrasound. Dr Goutham accepts referrals for unexplained biliary-type pain, suspected gallbladder dysfunction without stones, ongoing symptoms despite a previously normal ultrasound, and an abnormal gallbladder ejection fraction on a HIDA scan.
Diagnosis — the investigation pathway
- History & examination — a thorough review of symptoms, triggers and prior results.
- Blood tests — liver function tests, full blood count and pancreatic enzymes to exclude other causes.
- Abdominal ultrasound — to confirm there are no stones, duct dilatation or other abnormalities.
- A HIDA scan assesses bile flow and how well the gallbladder empties, reported as the gallbladder ejection fraction. Dr Goutham interprets the result alongside your symptoms and other tests, because a scan result alone cannot show whether gallbladder removal will relieve your pain.
- Further tests if needed — gastroscopy, MRCP or sphincter of Oddi assessment in selected cases.
Treatment options
Treatment depends on the pattern and severity of your symptoms, test results and the effect on daily life. Options may include dietary changes and symptom management, or laparoscopic (keyhole) gallbladder removal for selected patients. Surgery can help, but symptoms may continue afterwards. Dr Goutham will explain the likely benefits, alternatives and risks before you decide.
Before surgery
- Discuss risks & benefits
- Anaesthetic assessment
- Fasting & preparation
During surgery
- Four small incisions
- Gallbladder removed
- Typically 30–60 minutes
Recovery
- Discharge when your recovery allows
- Build up activity gradually
- Return to work and activity at your agreed pace
Life after gallbladder removal
You can live normally without a gallbladder: your liver continues to make bile, which flows directly into the intestine. Many people return to their usual diet, although loose stools or indigestion can occur. Persistent diarrhoea or abdominal symptoms deserve a review with your GP or treating team, especially if they affect daily life.
Read the gallbladder surgery recovery guide for more about recovery and returning to everyday activities.
Biliary dyskinesia vs other gallbladder conditions
Several conditions can cause similar upper-abdominal pain. Assessment helps distinguish gallbladder emptying problems from gallstones, cholecystitis (gallbladder inflammation), bile duct stones and functional gut disorders such as functional dyspepsia.
Evidence-based investigation and care
- ✓Biliary-tract expertise — extensive gallbladder surgery experience.
- ✓Focused assessment — your symptoms and test results considered together.
- ✓Minimally invasive technique — laparoscopic cholecystectomy.
- ✓Collaborative approach — with GPs and gastroenterologists.
- ✓Care close to home — Brisbane, Redland, Moreton Bay and Logan.
Biliary dyskinesia FAQs
Can I have gallbladder pain with a normal ultrasound?+
Yes. Gallbladder-type pain can occur without stones showing on ultrasound. Dr Goutham reviews the pain pattern and other findings to assess the likely cause; a HIDA scan may help when appropriate.
What is a HIDA scan and is it safe?+
A HIDA scan uses a radioactive tracer to show how bile moves through the liver, gallbladder and bile ducts. Medicine may be given to measure how the gallbladder empties. The test involves a small radiation exposure; other risks include bruising at the injection site or a reaction to the tracer. Tell the imaging team if you could be pregnant or are breastfeeding, and follow their preparation and medicine instructions.
Will removing my gallbladder fix the pain?+
Gallbladder removal can help selected patients with biliary dyskinesia, but it does not relieve everyone’s pain. Dr Goutham considers your symptoms, test results and other possible causes before recommending laparoscopic (keyhole) surgery.
What gallbladder ejection fraction is abnormal?+
A gallbladder ejection fraction below about 35% is often described as low, although the expected range depends on how the HIDA scan is performed. Dr Goutham interprets your ejection fraction, the proportion of bile the gallbladder releases, alongside your symptoms and other findings. The result informs the assessment rather than deciding treatment on its own.
How long is recovery after keyhole gallbladder surgery?+
After laparoscopic (keyhole) gallbladder removal, many people go home the same day or the next morning and plan one to two weeks off desk work. Recovery depends on the operation, your health and the demands of your work and daily activities. Use your discharge instructions for wound care, driving and activity, and follow the return-to-work plan agreed with your treating team. Open or more complex surgery may take longer to recover from.
Are there non-surgical options?+
Yes. Dietary changes and symptom management may help, particularly when symptoms are mild. If pain persists, Dr Goutham reviews your symptoms and investigation results to decide whether surgery or further assessment is appropriate.
Could my symptoms be something else?+
Yes — similar pain can come from reflux, functional dyspepsia, ulcers or other gut disorders, which is why careful assessment and the right tests are important before recommending surgery.
Will I need a special diet after surgery?+
Most people return to a normal diet. Some find it helpful to limit very fatty meals and increase fibre for the first few weeks while the body adjusts.
Caring for South-East Queensland
Dr Goutham consults and operates across Brisbane, Redland, Moreton Bay and Logan — care close to home, wherever you are in South-East Queensland.