Gallbladder sludge is a mixture of particulate matter and bile that occurs when solutes in bile precipitate. The formation of gallbladder sludge is due to an imbalance between bile salts and cholesterol, then the bile fluid turns to sludge. This thickened fluid consists of a mucus gel containing cholesterol and calcium bilirubinate. If the imbalance worsens, cholesterol crystals can eventually form gallstones.
It is generally a slow process, and usually causes no pain or other symptoms. The clinical course of biliary sludge varies. It can develop complications like abdominal pain, inflammation of biliary tract (i.e. cholecystitis), and formation of gallstone. However, in about 50% of cases, gallbladder sludge spontaneously disappears and in 20% of cases persists but no symptom over a 3-year period.
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