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Biliary Pain Without Gallstones

By

Christina C. Lindenmeyer

, MD, Cleveland Clinic

Last full review/revision Apr 2020| Content last modified Apr 2020
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Pain similar to that caused by gallstones sometimes occurs in people who have no gallstones or who have gallstones too small to be detected by ultrasonography. It is called acalculous biliary pain.

The gallbladder is a small, pear-shaped sac located beneath the liver. It stores bile, a fluid that is produced by the liver and aids in digestion. When bile is needed, as when people eat, the gallbladder contracts, pushing bile through the bile ducts into the small intestine. (See also Overview of Gallbladder and Bile Duct Disorders Overview of Gallbladder and Bile Duct Disorders The liver produces bile, a greenish yellow, thick, sticky fluid. Bile aids digestion by making cholesterol, fats, and fat-soluble vitamins easier to absorb from the intestine. Bile also helps... read more Overview of Gallbladder and Bile Duct Disorders .)

Acalculous biliary pain is most common among young women.

This disorder may develop when bile (produced by the gallbladder) does not pass through the ducts into the small intestine as it usually does. Passage of bile may be slowed or blocked because

Doctors suspect this disorder if people have biliary pain but ultrasonography shows no stones.

Surgical removal of the gallbladder (cholecystectomy) is usually done using a flexible viewing tube called a laparoscope. After small incisions are made in the abdomen, the laparoscope and surgical instruments are inserted through the incisions. Doctors then use instruments to remove the gallbladder.

Cholecystectomy may also cause symptoms to resolve if they were caused by gallstones that are too small to be detected by ultrasonography.

Drug therapies have no proven benefit.

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Primary Sclerosing Cholangitis
Primary sclerosing cholangitis is inflammation with progressive scarring and narrowing of the bile ducts, both inside and outside the liver. People with which of the following gastrointestinal issues are prone to developing this condition?
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