What is gallbladder sludge?

The proper term for gallbladder sludge is biliary sludge. It is a gelatinous bile that may be a precursor to cholesterol stones. However, in most cases, biliary sludge does not develop into a stone and dissolves within the gallbladder or may be passed out of the gallbladder.

What does gallbladder sludge mean?

Biliary sludge is normal and may be detected upon an ultrasound. It contains tiny sediments of calcium bilirubinate granules and cholesterol crystals. Mucus is also present and this is an important scaffolding for cholesterol stones. It should not be seen as a problem unless it is present for a prolonged period of time. Persistent  or excessive gallbladder sludge may result in the formation of gallbladder stones as it indicates that the conditions for cholesterol stone formation may be present. Biliary sludge often results in a false-negative for detecting very small stones on an ultrasound.

What causes gallbladder sludge?

The gallbladder is constantly concentrating bile. Sediments of calcium bilirubin and cholesterol may arise as water is removed from the bile. At the same time, mucus from the gallbladder lining may mix with these sediments and collect in the gallbladder. However, the body’s processes ensures that the sludge is cleared from the gallbladder.

Gallbladder sludge may be more prominent in pregnancy, with strict dieting and excessive fasting. It may also be seen in a person who is not eating food and being provided with nutrition via an intravenous drip (parenteral nutrition). In these cases, bile is not being passed out of the gallbladder as often as it should be. Due to the continuous production of bile by the liver , the gallbladder has to concentrate bile even further than normal in order to store it within its limited capacity. Greater concentration alters the solubilizing capacity of bile and may result in the sedimentation known as biliary sludge. It may also be related to other factors that cause bile stasis.

What are the symptoms of biliary sludge?

There is usually no symptoms associated with the presence of biliary sludge. However, if it leads to the formation of cholesterol stones, then the symptoms of gallstones may be present. It is also more likely to cause primary bile duct stones which are stones that form in the bile duct rather than gallstones that form in the gallbladder and then pass into the bile duct. Primary bile duct stones, like brown pigment stones, are often associated with bacterial or parasitic infections like a liver fluke.

Apart from gallstones, biliary sludge may lead to acute acalculous cholecystitis (inflammation of the gallbladder without the presence of gallstones). The symptoms of this condition closely resembles acute calculous cholecystitis (gallbladder inflammation due to gallstones) although it may be more gradual in onset.

It is important to remember that it is the small gallstones that are more likely to cause attacks of gallstone pain or lead to cholecystitis, cholangitis or even pancreatitis. Biliary sludge may not be responsible in these cases but since it may be responsible for a false-negative result for very small stones upon conducting an ultrasound, the sludge may be mistaken as the cause.

What is a gallbladder sludge flush?

The body has its own innate processes to rid the gallbladder of the sludge and if it is persistent, the causes of gallbladder sludge should be investigated and treated. Herbs and other natural products for a “gallbladder sludge flush” or liver flush are not necessary and should always be discussed with your doctor.

Understanding the process of bile production is important to understand how the gallbladder empties bile. Frequent meals increases gallbladder emptying and bile secretion and low-fat and low-sugar meals will reduce the risk of cholesterol stones. Refer to Foods to Avoids for Gallstone Prevention.

How is gallbladder sludge treated?

Treatment is not indicated for gallbladder sludge. If you have experienced recurrent gallstones and the stones have obstructed the bile duct(s) or is leading to complications, your doctor will consider a cholecystectomy (surgical removal of the gallbladder).

Related Articles

  1. Types of Gallstones
  2. Gallstones Causes
  3. Symptoms of Gallstones
  4. Gallstones Diet
  5. Gallbladder Removal Surgery

Article reviewed by Dr. Greg. Last updated on August 10, 2010