Biliary dyskinesia pathophysiology

The exact pathophysiology of biliary dyskinesia is unknown. However, there have been some suggestions as the causes of biliary dyskinesia such as the following: the biliary pain in gallbladder dyskinesia may be the result of gallbladder inflammation due ineffective gallbladder contraction caused by gallbladder dysmotility, visceral hypersensitivity, and receptor or neurologic abnormalities. Consequently, abnormality in gallbladder or sphincter of Oddi contraction results in inflammation and biliary pain.

• Biliary dyskinesia is characterized by low gallbladder ejection fraction during cholecystokinin-stimulated cholescintigraphy (CCK-CS).5
• The exact pathophysiology of biliary dyskinesia is unknown.^[1]
• However, the following suggestions have been proposed as the causes of biliary dyskinesia:^[2]
  • The biliary pain in gallbladder dyskinesia may be the result of gallbladder inflammation due ineffective gallbladder contraction caused by gallbladder dysmotility following a change in bile composition.^[3][4][5]
  • May be the result of visceral hypersensitivity (hypersensitivity of the neural pathways communicating with the intestines) seen in patients with sphincter of Oddi dysfunction or irritable bowel syndrome.^[3][6]
  • May be the result of receptor/neurologic abnormalities (such as problems in cholecystokinin (CCK) release, decreased sensitivity or density of CCK receptor in the gallbladder, or increased sensitivity of CCK receptor in the cystic duct with impaired contractility of the smooth muscle.^[7]

• Consequently, abnormality in gallbladder or sphincter of Oddi contraction results in inflammation and biliary pain.^[1]