Viewer's Question:What is biliary sludge?
Doctor's Response:Biliary sludge is a mixture of particulate matter and mucous that forms in bile. (Bile is the yellow-brown fluid that drains from the liver into the gallbladder where it is stored and concentrated. After meals the gallbladder contracts, squirting the bile through the common bile duct into the duodenum, where it helps to digest the fat in meals.) The composition of biliary sludge varies. The most common particulate matter in biliary sludge is cholesterol crystals and calcium salts. Occasionally drugs may comprise the particulate matter since bile is one of the major routes for excretion of drugs.
Biliary sludge has been associated with certain conditions including rapid weight loss, pregnancy, medications (ceftriaxone, octreotide), and bone marrow or solid organ transplantation.
Biliary sludge may cause no symptoms or cause intermittent symptoms. Biliary sludge also can progress to gallstones or completely resolve.
Symptoms of biliary sludge include pain in the abdomen, nausea and vomiting, particularly after a fatty meal.
Biliary sludge can cause complications, including pain from obstruction of the bile ducts (biliary colic), inflammation of the pancreas (pancreatitis), and inflammation of the gallbladder (cholecystitis).
Biliary sludge can be detected with ultrasound of the abdomen, by endoscopic ultrasonography (ultrasonography done through an endoscope) or by directly examining bile contents under a microscope (bile microscopy).
If patients with biliary sludge develop symptoms or complications, gallbladder removal (cholecystectomy) is performed as treatment.
Last Editorial Review: 3/7/2003