The gallbladder is located between the intestines and the liver. It stores bile from the liver until it’s time to release it into the intestines to aid in digestion.
If the gallbladder doesn’t empty completely, particles in the bile — like cholesterol or calcium salts — can thicken as a result of remaining in the gallbladder for too long. They eventually become biliary sludge, which is commonly referred to as gallbladder sludge.
Some people who have gallbladder sludge will show no symptoms and never know that they have it. Others will experience symptoms consistent with an inflamed gallbladder or gallbladder stones. The primary symptom is often abdominal pain, especially on your upper right side under the ribs. This pain may increase shortly after a meal.
Other symptoms can include:
- chest pain
- right shoulder pain
- nausea and vomiting
- clay-like stools
Gallbladder sludge forms when bile remains in the gallbladder for too long. Mucus from the gallbladder can mix with cholesterol and calcium salts, combining to create the sludge.
Gallbladder sludge seems to be more common during pregnancy, especially if you’re following a strict diet.
While gallbladder sludge is not a common problem, there are certain people who have a higher risk for developing it. Groups who are at a higher risk include:
- women, who have higher rates of gallbladder problems than men
- people with Native American ancestry
- people who are getting nutrition through an IV or another alternative to food
- people who are critically ill
- people with diabetes
- people who were very overweight and lost weight very quickly
- people who have had an organ transplant
If you’re experiencing abdominal pain, your doctor will ask about your medical history and your symptoms. They’ll then perform a physical exam, pressing on different places on your abdomen. If they suspect that your gallbladder may be the source of the pain, they’ll likely order an abdominal ultrasound, which can pick up gallstones with remarkable accuracy.
If your doctor diagnoses you with gallstones or gallbladder sludge after the ultrasound, they may run tests to determine the cause of the sludge. This will likely include a blood test, which can examine your cholesterol and sodium levels. Your doctor may also run blood tests to ensure that your liver is functioning properly.
Sometimes doctors will find your gallbladder sludge by accident while looking at the results of a CT scan or ultrasound that was ordered for something else.
Sometimes, gallbladder sludge will resolve without causing any symptoms or needing treatment. In other situations it can lead to gallstones. Gallstones can be painful and cause upper abdominal pain, and may require surgery. In some cases, these gallstones can cause an obstruction in the bile duct. This is a medical emergency and requires immediate treatment.
Gallbladder sludge can cause or contribute to cholecystitis, or an inflamed gallbladder. If your gallbladder causes frequent or chronic pain, your doctor will likely recommend removing the gallbladder entirely.
In very severe cases, an inflamed gallbladder can cause erosion in the wall of the gallbladder, leading to a perforation that leaks the contents of the gallbladder into the abdominal cavity. This is most common in older adults.
Gallbladder sludge may also cause acute pancreatitis, or inflammation of the pancreas. This can cause enzymes to be active in the pancreas instead of the intestines, leading to inflammation. The inflammation can cause a systemic response, leading to shock or even death. This can occur if the gallbladder sludge or gallstones block the pancreatic duct.
If your gallbladder sludge isn’t causing any symptoms, it’s possible that no treatment will be necessary. Once the underlying cause clears up, the sludge often disappears.
Your doctor can prescribe medications to help dissolve the sludge or any gallstones it could lead to.
In some cases, when the sludge causes pain, inflammation, or gallstones, your doctor may recommend removing the gallbladder altogether.
If gallbladder sludge is a recurring problem, you may need to make lifestyle changes to prevent future problems. By eating a low-fat, low-cholesterol, and low-sodium diet, you can reduce the chance of developing sludge in the future.
Many people with gallbladder sludge will never even know they had it, especially in cases where the cause is only temporary. If the gallbladder sludge leads to further complications or causes chronic pain, your doctor may recommend removing the gallbladder altogether. Gallbladder sludge typically isn’t a problem unless it’s experienced over a long period of time, or it causes symptoms.
To prevent gallbladder sludge, try to eat a healthy, well-balanced diet low in sodium, fats, and cholesterol.