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PubMed This is a summary of 15 peer-reviewed journal articles Updated
Gastroenterology · Functional Gallbladder Disorder

Building Your Care Team & First Visit Prep

At a Glance

For biliary dyskinesia, careful specialist review is especially important when scans look normal. Bring the complete HIDA protocol, original imaging, lab results, prior testing, medication and fasting history, and a detailed symptom log to help avoid unnecessary surgery.

Navigating a diagnosis of Functional Gallbladder Disorder requires a care team that looks beyond “normal” test results [1]. Because this condition is defined by how the gallbladder functions rather than how it physically looks, you need clinicians who are willing to investigate the nuances of your symptoms and the technical details of your scans [2][3].

Your Care Team and Second Opinions

While many patients are treated successfully by a general surgeon, if your symptoms are atypical or your diagnosis is uncertain, seeking a multidisciplinary review or a second opinion can be highly beneficial [4][2].

  • The Gastroenterologist (GI): A GI specialist can help confirm that your pain fits the “typical biliary” pattern and formally rule out look-alike conditions such as stomach ulcers, acid reflux, or functional dyspepsia [1][5]. They ensure that the problem is truly the biliary system and not a broader issue with your digestive tract [6].
  • The General Surgeon: The surgeon performs the laparoscopic cholecystectomy (gallbladder removal). It is helpful to consult a surgeon who is experienced in evaluating biliary pain without visible stones, as these cases require a more careful patient selection process than standard gallstone surgery [3][7].

Essential Records for Your Consultation

When you meet with a specialist, bringing the full “physical artifacts” of your journey is critical. Relying on a brief summary from another doctor is often not enough to make an informed decision [8][9]. You should bring:

  1. The Complete HIDA Scan Report: Do not just bring the Ejection Fraction percentage. Your specialist needs to see the acquisition protocol: the dose of sincalide used, the duration of the infusion (ideally 60 minutes), and whether your typical pain was reproduced during the test [8][10].
  2. Original Ultrasound Reports and Images: While the written report may say “normal,” a specialist may want to review the images themselves to look for subtle signs of sludge that might have been overlooked [9][7].
  3. Actual Laboratory Results: Bring the raw numbers from your liver and pancreatic blood tests, not just a note that they were “normal.”
  4. Prior Endoscopy or Cross-Sectional Imaging: If you have had an upper endoscopy or a CT scan, bring those detailed reports.
  5. Detailed Symptom Log: Bring a log documenting the start and end time of episodes, location, severity, whether it is related to bowel movements or posture, and the impact on your activities [11][12].
  6. Medication and Fasting History: Provide a list of all medications you were taking (and the exact timing of when you paused them) and your exact fasting times prior to your HIDA scan [13][7].

A care team that takes the time to thoroughly review these records is not trying to delay your relief; they are protecting you from the risk of an unnecessary surgery [14]. When the clinical picture is clear, the likelihood of a successful outcome after surgery is significantly improved [12][15].

Common questions in this guide

Which specialists should I see for biliary dyskinesia?
A gastroenterologist can assess whether your pain fits a typical biliary pattern and help rule out conditions such as ulcers, reflux, or functional dyspepsia. A general surgeon can evaluate whether laparoscopic gallbladder removal is appropriate, especially when there are no visible gallstones.
What should I bring to an appointment for biliary dyskinesia?
Bring the complete HIDA scan report, including the sincalide dose, infusion length, and whether your usual pain occurred during the test. Also bring original ultrasound reports and images, laboratory results, prior endoscopy or CT reports, a detailed symptom log, and your medication and fasting history.
Why is the HIDA scan protocol important?
The final ejection fraction is only one part of a HIDA scan. The medication dose, infusion duration, fasting history, and whether typical pain was reproduced can help a specialist understand how meaningful the result is.
Can biliary dyskinesia be considered when an ultrasound looks normal?
Yes. Functional gallbladder disorder is defined by how the gallbladder works rather than only by how it appears on imaging, so a person may have biliary pain without visible gallstones. A specialist may still review the original images and evaluate other digestive causes of pain.
Would a second opinion help if my biliary dyskinesia diagnosis is uncertain?
A second opinion or multidisciplinary review can be useful when symptoms are atypical, test details are incomplete, or clinicians disagree about the diagnosis. Reviewing the full clinical history and original test materials can help clarify whether surgery is likely to help.
What should I ask a surgeon before gallbladder removal?
Ask how often the surgeon evaluates biliary pain without visible stones, what their complication rates are, and what they would do if surgery does not relieve your pain. You can also ask whether a gastroenterology consultation or a period of observation would be reasonable.

Get notified when new evidence is published on biliary dyskinesia.

We monitor PubMed for new peer-reviewed studies on this topic and email a short summary when something meaningful changes.

References

References (15)
  1. 1

    Biliary Dyskinesia and Hyperkinesis.

    Tseng J, Chen Y, McDonald C

    The Surgical clinics of North America 2024; (104(6)):1191-1201 doi:10.1016/j.suc.2024.04.007.

    PMID: 39448121
  2. 2

    Hyperkinetic Biliary Dyskinesia: An Underrecognized Problem With Good Surgical Outcomes After Cholecystectomy.

    Camacho KD, Cohen RB, Kapadia S, et al.

    Cureus 2024; (16(6)):e63237 doi:10.7759/cureus.63237.

    PMID: 39070494
  3. 3

    Role of laparoscopic cholecystectomy in the management of chronic right upper quadrant pain due to biliary dyskinesia: a systematic review and meta-analysis.

    Rehman S, Singh KK, Sajid MS

    Translational gastroenterology and hepatology 2019; (4()):71 doi:10.21037/tgh.2019.08.10.

    PMID: 31620653
  4. 4

    Decision-making patterns in managing children with suspected biliary dyskinesia.

    Nakayuenyongsuk W, Choudry H, Yeung KA, Karnsakul W

    World journal of clinical pediatrics 2017; (6(2)):124-131 doi:10.5409/wjcp.v6.i2.124.

    PMID: 28540197
  5. 5

    Biliary Dyskinesia in Children: A Systematic Review.

    Santucci NR, Hyman PE, Harmon CM, et al.

    Journal of pediatric gastroenterology and nutrition 2017; (64(2)):186-193 doi:10.1097/MPG.0000000000001357.

    PMID: 27472474
  6. 6

    Functional Gallbladder Disorders: Are We Missing Gallstones?

    Kendric TJG, Apikotoa SA, Ng ZQ, Wijesuriya R

    World journal of surgery 2026; (50(2)):353-359 doi:10.1002/wjs.70230.

    PMID: 41506661
  7. 7

    Biliary Dyskinesia-Controversies, Diagnosis, and Management: A Review.

    Richmond BK

    JAMA surgery 2024; (159(9)):1079-1084 doi:10.1001/jamasurg.2024.0818.

    PMID: 38959007
  8. 8

    Sincalide-Stimulated Cholescintigraphy: A Retrospective Study and Proposal of a Modified Workflow.

    Vasireddi A, Nguyen NC

    Clinical nuclear medicine 2022; (47(1)):1-6 doi:10.1097/RLU.0000000000003959.

    PMID: 34874343
  9. 9

    Biliary Dyskinesia with Reduced Gallbladder Ejection Fraction: A Diagnostic and Therapeutic Shift in Management.

    Elaskandrany MA, Ismail M, Liu Y, Wang WW

    Journal of Brown hospital medicine 2025; (4(1)):6-9 doi:10.56305/001c.127836.

    PMID: 40027459
  10. 10

    HIDA scan for functional gallbladder disorder: ensure that you know how the scan was done.

    Goussous N, Maqsood H, Spiegler E, et al.

    Hepatobiliary & pancreatic diseases international : HBPD INT 2017; (16(2)):197-201 doi:10.1016/s1499-3872(16)60188-1.

    PMID: 28381385
  11. 11

    The Management of Dysfunctional Gallbladder Disease and the Role of Laparoscopic Cholecystectomy on Symptom Improvement: A Retrospective Cohort Study.

    Abuahmed MY, Wuheb A, Eskandar G, et al.

    Cureus 2024; (16(7)):e64726 doi:10.7759/cureus.64726.

    PMID: 39156402
  12. 12

    Cholescintigraphy may have a role in selecting patients with biliary dyskinesia for cholecystectomy: a systematic review.

    Alhayo S, Eslick GD, Cox MR

    ANZ journal of surgery 2020; (90(9)):1647-1652 doi:10.1111/ans.16003.

    PMID: 32479706
  13. 13

    HIDA and Seek: Challenges of Scintigraphy to Diagnose Bile Reflux Post-Bariatric Surgery.

    Eldredge TA, Bills M, Myers JC, et al.

    Obesity surgery 2020; (30(5)):2038-2045 doi:10.1007/s11695-020-04510-7.

    PMID: 32133588
  14. 14

    Systematic review with meta-analysis: cholecystectomy for biliary dyskinesia-what can the gallbladder ejection fraction tell us?

    Gudsoorkar VS, Oglat A, Jain A, et al.

    Alimentary pharmacology & therapeutics 2019; (49(6)):654-663 doi:10.1111/apt.15128.

    PMID: 30706496
  15. 15

    Functional gallbladder disorder: Interim analysis of a prospective cohort study.

    Xu KJ, Brock JC, Goussous N, et al.

    American journal of surgery 2024; (229()):129-132 doi:10.1016/j.amjsurg.2023.12.010.

    PMID: 38110322

This page is for informational purposes only and does not constitute medical advice. A gastroenterologist and surgeon can help interpret your HIDA scan and decide whether gallbladder surgery is appropriate for your situation.

Guide contents biliary dyskinesia
Research & Literature
04 Making the Treatment Decision 06 After Surgery