Biliary Dyskinesia in Brisbane
Investigation and management of biliary dyskinesia — gallbladder-type pain without stones — by Dr Goutham Sivasuthan, with HIDA-guided diagnosis and keyhole treatment where appropriate, across Brisbane, Redland, Moreton Bay and Logan.
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.
Because routine ultrasound often looks completely normal, biliary dyskinesia is frequently missed or mistaken for other conditions. Dr Goutham regularly sees patients with this frustrating problem, providing advanced diagnostic work-up — particularly the HIDA scan that measures gallbladder function — and minimally invasive surgical treatment when it is appropriate.
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
The exact cause is not always clear, but contributing factors include abnormal gallbladder muscle contraction, nerve-signalling problems that affect emptying, sphincter of Oddi dysfunction, hormonal influences and prior digestive inflammation. Biliary dyskinesia can occur at any age but is most often diagnosed in adults aged 20–50, and it affects women more often than men.
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.
- HIDA scan with CCK — the key test. It measures the gallbladder ejection fraction (GBEF); a low value (commonly under 35%) supports the diagnosis, particularly if the injection reproduces your typical pain.
- Further tests if needed — gastroscopy, MRCP or sphincter of Oddi assessment in selected cases.
Treatment options
Management depends on the severity of your symptoms, your scan results and the impact on your quality of life. Mild cases may be managed conservatively with dietary changes and symptom control. When symptoms persist and a HIDA scan confirms poor gallbladder function, laparoscopic (keyhole) cholecystectomy is often the most effective treatment, with many patients reporting significant or complete relief.
Before surgery
- Discuss risks & benefits
- Anaesthetic assessment
- Fasting & preparation
During surgery
- Four small incisions
- Gallbladder removed
- Typically 30–60 minutes
Recovery
- Often discharged within 24h
- Light activity in a few days
- Full recovery 1–2 weeks
Life after gallbladder removal
You can live a completely normal life without a gallbladder — the liver continues to produce bile, which flows directly into the intestine. Most people eat normally afterwards, though about one in five notice softer or more frequent stools for a few weeks, easily managed with more fibre and fewer very fatty meals. These changes almost always settle as the body adapts.
Biliary dyskinesia vs other gallbladder conditions
Accurate diagnosis avoids unnecessary procedures and ensures the right treatment. Biliary dyskinesia is distinguished from gallstones (visible on ultrasound), cholecystitis (inflammation with infection), choledocholithiasis (stones in the bile ducts) and functional dyspepsia or other functional gut disorders, which can produce similar upper-abdominal symptoms.
Evidence-based investigation and care
- ✓Biliary-tract expertise — extensive gallbladder surgery experience.
- ✓Targeted diagnosis — HIDA-guided, avoiding unnecessary surgery.
- ✓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. Biliary dyskinesia causes gallstone-like pain even when ultrasound is normal, because the problem is gallbladder function rather than stones. A HIDA scan measuring the ejection fraction helps confirm it.
What is a HIDA scan and is it safe?+
A HIDA scan is a safe nuclear-medicine test that tracks bile flow and measures how well the gallbladder empties. A medication (CCK) may be given to stimulate the gallbladder and measure its ejection fraction.
Will removing my gallbladder fix the pain?+
For patients with confirmed poor gallbladder function on HIDA, laparoscopic cholecystectomy resolves or significantly improves symptoms in the majority of cases.
What gallbladder ejection fraction is abnormal?+
A GBEF below about 35% is generally considered low and supports the diagnosis, especially when the test reproduces your usual pain. Dr Goutham interprets the result alongside your symptoms.
How long is recovery after keyhole gallbladder surgery?+
Most patients are discharged within 24 hours, return to light activity within days, and fully recover in 1–2 weeks.
Are there non-surgical options?+
Mild cases may improve with a lower-fat diet and symptom management. Surgery is reserved for patients with persistent symptoms and confirmed poor gallbladder function.
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.
Trusted resources
Last medically reviewed by Dr Goutham Sivasuthan, specialist surgeon — June 2026.
Ongoing gallbladder pain without stones?
Even with a normal ultrasound, expert evaluation can find the cause. Book an assessment with Dr Goutham.