Gallbladder Sludge: What It Is and How to Treat It

The widespread use of new weight-loss drugs is helping millions of people shed unhealthy pounds, but losing weight too quickly is a risk factor for developing gallbladder sludge, a frequent precursor to more serious digestive problems.

Gallbladder sludge is a mixture of solids, including cholesterol and calcium, that have dropped out of bile, a greenish-yellow digestive fluid manufactured in the liver and condensed and stored in the gallbladder before being released into the digestive tract.

Buildup of this thick, wet material, also called biliary sludge, may not cause any symptoms, but when it does, you should seek treatment to avoid more serious complications.

What Does the Gallbladder Do?

The pear-shaped gallbladder works with the liver as part of the digestive system. When you eat fatty food, hormones tell the gallbladder to release bile, which helps digest fat and eliminate waste products.

When you fast or lose weight too quickly, the gallbladder doesn't contract as often, which means bile sits stagnant for longer periods. This allows cholesterol and other substances in the bile to concentrate and form crystals or sludge. Additionally, during rapid weight loss, the liver secretes more cholesterol into the bile, increasing the risk of gallstone formation.

This combination of stasis and cholesterol saturation creates the perfect environment for sludge and gallstones to develop. Critically ill patients whose only food comes from an IV are at risk for the same reason, and pregnancy brings hormonal changes that also can raise the risk.

Possible Complications

You may have no symptoms from gallbladder sludge, in which case your healthcare provider likely will advise monitoring the situation. However, if you experience abdominal pain, especially in the upper right side; nausea and vomiting, or bloating, you should seek treatment because they could signal a serious complication, including:

• Biliary colic — temporary but intense abdominal pain caused by blockage of a bile duct
• Cholecystitis— inflammation of a bile duct or the gallbladder
• Acute pancreatitis — inflammation of the pancreas if the sludge blocks the pancreatic duct
• Gallstones — hardened deposits that can move and block a duct

To diagnose the cause of your pain, your healthcare provider may order an abdominal ultrasound, which uses sound waves to create a picture of your gallbladder and bile ducts, revealing gallbladder sludge, gallstones and blockages, if any.

How Is It Treated?

Asymptomatic gallbladder sludge may resolve on its own. Your health care provider may recommend a diet that is low-fat, low-cholesterol and high in fiber. You should also try to maintain a healthy weight; gallbladder problems are more likely in those who are overweight.

However, if you have recurring, frequent abdominal pain, you may be advised to have your gallbladder -- a nonessential organ -- surgically removed. That procedure, called a cholecystectomy, is one of the most frequently performed surgeries in the United States, with more than 1.2 million performed annually.

Removal of your problematic gallbladder should eliminate your abdominal pain. As your body adjusts, you may be advised to limit high-fat foods and eat smaller, more frequent meals, focusing on fruits, vegetables, lean proteins and whole grains.