The document discusses biliary dyskinesia, a disorder where the gallbladder does not contract and empty properly, causing digestive issues. It describes the anatomy and role of the biliary system, signs and symptoms of biliary dyskinesia including abdominal pain and nausea, potential causes, diagnostic tests and treatments including diet changes and medication. Nutritional guidelines recommend a low-fat diet, fiber, staying hydrated, supplements, weight management and probiotics to support gallbladder function and digestion.

1. Biliary Dyskinesia

2. Learning Objectives
• Identify Biliary Dyskinesia Sign Symptoms.
• Explore Causes and Key Nutrients' Role.
• Discuss Treatment Options and Dietary
Guidelines.
• Promote Multidisciplinary Care Awareness.

3. Introduction
• A Disorder of the Gallbladder
• Biliary Dyskinesia, a motility disorder affecting
the gallbladder's ability to contract and relax
properly, leading to digestive issues.
• Biliary Dyskinesia (BD) is a disorder affecting
the gallbladder.
• It is characterized by inflammation, abnormal
contraction, and emptying of the gallbladder.

4. Brief Introduction
• Biliary Dyskinesia is a functional disorder
primarily affecting the gallbladder.
• It may also involve the small muscle (sphincter)
where bile empties into the small intestine.
• Unlike mechanical blockages, it is a problem with
the organ's or muscle's functioning.
• The gallbladder's main role is to store bile from
the liver and release it into the small intestine
during digestion.
• If the sphincter is scarred or has spasms, bile
cannot flow out of the gallbladder. The bile then
flows back into the gallbladder and causes pain.

5. The Anatomy and physiology of the
Biliary System
• Biliary System
Anatomy
• Structure
• Role of the
gallbladder in
digestion and bile
absorption,
• Bile Flow Through
the Biliary System
• Anatomical
Variations

6. Clinical Signs and symptoms
• Biliary Dyskinesia (BD) is a disorder that involves abnormal
gallbladder functioning, leading to various signs and symptoms.
• Abdominal Pain: Recurrent, intermittent pain in the upper right
quadrant of the abdomen, often radiating to the back or right
shoulder blade.
• Nausea and Vomiting: Episodes of nausea and vomiting,
particularly after consuming fatty or greasy foods.
• Bloating and Indigestion: Complaints of bloating and indigestion
after meals.
• Lower Abdominal Cramping: Cramping and discomfort in the lower
abdomen.
• Dyspepsia: Experience of indigestion and discomfort in the upper
abdomen.
• Fatty Food Intolerance: Worsening of symptoms after eating fatty
or greasy foods.

7. Risk Factors
• The possible risk factors of biliary dyskinesia
include:
• Advanced age
• Obesity
• Female gender
• Stress
• Gallbladder inflammation
• Gastrointestinal disease
• Hypothyroidism

8. Causes and pathophysiology of Biliary
Dyskinesia
The exact cause of biliary dyskinesia is unknown.
• There are several risk factors that, when
combined, put a person at a greater risk of
developing the disorder. This includes:
 Previous history of gallstones
 Inflammation of the gallbladder
 A compromised immune system
 Being overweight or obese
 using specific medications such as antibiotics.
 persons who have a history of abdominal surgery

9. Gallbladder Motility disorders
• Motility Disorders:- Hypomotility: Decreased contractility
leading to sluggish gallbladder contractions.-
• Hypermotility: Increased contractility causing rapid and
irregular contractions.
• Impaired Gallbladder Function and Bile Flow:-
• Hypomotility: Reduced bile release into the
digestive tract.
• Hypermotility: Inadequate bile storage and
controlled bile release.- Both conditions disrupt
bile flow, impacting fat digestion and nutrient
absorption

10. Impaired Gallbladder Function Impact
on Bile Flow and Digestion.
• Bile's Role in Digestion:- Emulsifies fats,
increasing their surface area for enzyme
action.- Aids fat digestion and absorption of
fat-soluble vitamins (A, D, E, K).
• Impact of Impaired Function:- Hypomotility:
Fat malabsorption, potential nutrient
deficiencies.- Hypermotility: Digestive
disturbances, inadequate fat breakdown.

11. Diagnosis of Biliary Dyskinesia (BD)
• The following diagnostic tests or procedures may be ordered:
• Liver Function Test: Determines the health of your liver, gallbladder
and bile ducts.
• Cholecystokinin Hepatobiliary (CCK-HIDA) Scan: A small amount of
radioactive dye and enzyme cholecystokinin is injected followed by
a fatty meal. A nuclear medicine camera helps your doctor see how
well bile is secreted from your gallbladder.
• Imaging Tests: Images of your gallbladder are obtained by
performing CT scan, MRI, Ultrasound, etc.
• Endoscopic Retrograde Cholangiography (ERCP): is a procedure to
examine bile ducts. An endoscope is inserted through the mouth
into the opening between the stomach and small intestine. X-rays
are taken with the help of contrast liquid. Inform the provider of
any prior allergic reactions to contrast.

12. Treatment
• Pain Management:
• Prescription pain medicines or NSAIDs (non-steroidal anti-
inflammatory drugs) are used to manage pain associated
with Biliary Dyskinesia.
• Lifestyle Changes:
• Dietary modifications: A low-fat diet may help alleviate
symptoms.
• Weight management and regular physical activity can be
beneficial.
• Medications:
• Antispasmodics: These medications help relax the
gallbladder muscles and reduce pain.
• Bile acid sequestrants: They may aid in binding excess bile
and reducing symptoms.

13. Treatment conti..
• Surgical Option - Laparoscopic Cholecystectomy:
• Laparoscopic cholecystectomy is a common surgical
procedure for Biliary Dyskinesia.
• The surgery is performed under general anesthesia.
• Small incisions are made in the upper abdomen.
• A laparoscope with a camera is inserted to view the inside
of the abdomen.
• The gallbladder is isolated, separated from the liver, and
carefully removed.
• The incisions are closed, and the patient may experience a
faster recovery compared to traditional surgery.

14. Nutritional treatment and dietary
guidelines for Biliary Dyskinesia (BD)
• focuses on managing symptoms, supporting
gallbladder function, and promoting overall
digestive health. Dietary modifications can
help reduce pain, improve bile flow, and
enhance digestion.
• Here are some key aspects of nutritional
management for BD:

15. • Low-Fat Diet: A low-fat diet is often recommended to ease the workload
on the gallbladder and reduce symptoms. Limiting the intake of fatty and
greasy foods can help prevent excessive bile secretion and ease
gallbladder contraction.
• Lean protein foods — Including lean sources of organic protein in a
gallbladder diet can relieve stress. Consider chicken, turkey, grass-fed beef,
bison, wild-caught fish and organic protein powder, including protein from
bone broth powder.
• High-Fiber Foods: Including foods high in soluble fiber, such as oats,
legumes, fruits, and vegetables, can aid in proper digestion and promote
regular bowel movements. Fiber also binds to bile acids, helping in their
elimination.
• Avoiding Trigger Foods: Some individuals may have specific trigger foods
that worsen their symptoms. These may include spicy foods, fried foods,
and processed foods. Identifying and avoiding these triggers can be
beneficial.
• Adequate Hydration: Staying well-hydrated is essential for overall health
and can help maintain proper bile consistency.
• Cholesterol Management: High cholesterol levels can contribute to
gallbladder issues. Maintaining healthy cholesterol levels through diet and
lifestyle changes is crucial.
• Smaller, Frequent Meals: Eating smaller, more frequent meals instead of
large meals can help reduce stress on the gallbladder and promote better
digestion.

16. • Vitamin and Mineral Supplementation: If a deficiency in
certain vitamins or minerals is identified, supplementation
may be recommended.
• Weight Management: Maintaining a healthy weight is
important for overall health and can help prevent gallbladder
issues.
• Probiotics: Probiotics, found in fermented foods and
supplements, can support gut health and aid digestion.
• Unrefined healthy fats (including olive or coconut oil) .
Moderate intake of unrefined healthy fats (coconut and olive
oil) with medium-chain fatty acids aids digestion. Consume in
small amounts (1 tbsp oil or 2 tbsp sprouted nuts/seeds) to
avoid burdening the liver and gallbladder while benefiting
from their anti-inflammatory properties.

17. Use Gallbladder Herbs, Acids and
Enzymes