17099 Hida Scan

Overview

A HIDA scan is a painless imaging test that shows how well your gallbladder and bile ducts are working. 'HIDA' stands for hepatobiliary iminodiacetic acid — that is the name of a safe, slightly radioactive liquid (called a tracer) that is used during the test. A technician puts a small amount of this tracer into a vein in your arm. Your liver takes it up and sends it out along your bile ducts into your gallbladder. A special camera then takes pictures of the tracer as it moves through your body. Because the tracer shows up on the pictures, your doctor can see whether bile is flowing normally, whether anything is blocking the flow, and whether your gallbladder squeezes the way it should. It is sometimes also called a hepatobiliary scan, a gallbladder scan, or a cholescintigraphy scan.

Yes. A HIDA scan is a routine test in hospital imaging departments. It is one of the standard ways to check the gallbladder when other tests, such as an ultrasound, do not give a clear answer.

Anyone can be sent for a HIDA scan, from children to older adults. It is most often done for adults who have ongoing pain in the upper right side of the belly, nausea after eating, or symptoms that suggest a gallbladder problem. Gallbladder problems are more common in women, in people who are overweight, and in people who have lost weight very quickly.

Symptoms

Common symptoms

• Pain or aching in the upper right side of your belly, sometimes spreading to your back or right shoulder
• Pain that comes on 15 to 30 minutes after a fatty or heavy meal
• Feeling sick (nausea) or being sick after eating
• Bloating, burping, or a lot of gas after meals
• Feeling full very quickly when eating
• Yellowing of the skin or the whites of the eyes (jaundice) in some people
• Pale, clay-coloured stools or dark urine if a bile duct is blocked
• Fever or chills if there is an infection

Symptoms in children

• Tummy aches that keep coming back, often after meals
• Being fussy or refusing food in younger children
• Being sick after eating
• Yellowing of the skin or eyes, which needs to be checked quickly
• A HIDA scan is used less often in children, but it is safe and is sometimes needed when other tests are unclear

Symptoms in older adults

• Pain may be milder or even absent, even when something is seriously wrong
• Confusion or unusual sleepiness can sometimes be the main sign of infection
• Fever may be low or missing
• Symptoms can come on more quickly, so it is worth getting checked early

Causes

Main causes

• The scan is done to look for the cause of symptoms, rather than being caused by something itself. Common reasons to have a HIDA scan include:
• Gallstones blocking the flow of bile out of the gallbladder
• Inflammation of the gallbladder (cholecystitis) — this means the gallbladder is irritated and swollen
• A blockage or narrowing in the bile ducts, the tubes that carry bile from the liver
• A bile leak after gallbladder surgery
• A gallbladder that squeezes poorly, sometimes called biliary dyskinesia — this means the gallbladder works abnormally even when there are no stones
• Problems after liver transplant or certain types of liver disease, in some cases

Risk factors

• Things that make gallbladder problems more likely include:
• Being female
• Being overweight or having obesity
• Losing weight very quickly, including after weight-loss surgery
• Being pregnant
• Being over the age of 40
• A family history of gallstones
• Some long-term health conditions, such as diabetes or liver disease
• Some medicines, including certain hormone treatments — ask your doctor or pharmacist about your own medicines

When to see a doctor

See a doctor urgently if:

• You have severe belly pain, especially in the upper right side
• You have belly pain with a fever or chills
• Your skin or the whites of your eyes look yellow
• Your stools look pale or your urine looks dark
• You keep being sick and cannot keep fluids down
• You have pain after eating that is getting worse or more frequent

Book a routine appointment if:

• You get repeated bouts of indigestion or bloating after fatty meals
• You have discomfort under your right ribs that keeps coming back
• You have been told you have gallstones and want to talk about your options
• You are due to have a HIDA scan and have questions about how to prepare
• You have questions about the results of a scan you have already had

Diagnosis

A HIDA scan is itself a test, not a diagnosis. Your doctor will first ask about your symptoms and examine your belly, then arrange blood tests and usually an ultrasound scan. If those do not explain your symptoms, a HIDA scan can show how your gallbladder and bile ducts are working. The results are looked at by a specialist doctor called a radiologist, who writes a report for the doctor who referred you.

Tests that may be done

• A conversation about your symptoms, diet, and medical history
• A physical examination of your belly
• Blood tests to check your liver and look for signs of infection or inflammation
• An ultrasound scan of your belly, which is usually the first imaging test
• The HIDA scan itself
• Sometimes other imaging such as a CT scan or an MRI scan of the bile ducts
• In some cases, an endoscopy — a camera test — to look at the bile ducts from the inside

What to expect at your appointment

You will usually be asked not to eat for about 4 to 6 hours before the test, though you can normally drink water. Tell the staff if you are pregnant, might be pregnant, or are breastfeeding, and tell them about any allergies and all your medicines. On the day, you will change into a hospital gown and lie on a scanning bed. A small needle is placed in a vein in your arm, and the tracer is injected. The camera is positioned close to your belly and takes pictures over roughly an hour. In some cases you will be given a small fatty drink or a medicine to make your gallbladder squeeze, and more pictures are taken. You lie still but you do not have to hold your breath. You can usually go home straight afterwards and eat and drink normally. The tracer leaves your body naturally in your urine and stools over a day or so, and drinking plenty of water helps. Most people feel completely fine afterwards.

Treatment

What happens after your HIDA scan depends entirely on what it shows. If the scan is normal, no treatment may be needed and your doctor will look for other reasons for your symptoms. If it shows gallstones, inflammation, a blockage, or a gallbladder that works poorly, your doctor will talk you through the options. These range from watching and waiting, to changes in diet, to surgery to remove the gallbladder, which is a very common and well-understood operation.

Self-care at home

• Keep a simple diary of when pain comes on and what you ate beforehand — this helps your doctor a lot
• Eat smaller meals more often rather than one large heavy meal
• Notice whether fatty, fried, or very rich foods trigger your symptoms, and cut back if they do
• Drink plenty of water after your scan to help clear the tracer from your body
• Stay gently active — a short walk after meals can help with bloating
• Avoid crash diets and very fast weight loss, which can make gallstones more likely
• Ask your pharmacist before starting any new medicine, including herbal remedies

Medical treatments

Treatment is planned around what the scan finds. For mild symptoms, your doctor may suggest watching and waiting, plus changes to how you eat. For pain, they will discuss pain relief options with you — always follow their advice and never take more than the label or your doctor says. If there is an infection or inflammation, you may need to be in hospital for fluids, monitoring, and treatment given through a drip. If a bile duct is blocked, a specialist can sometimes clear it using a camera test called an endoscopy, without a big operation. Some people are offered medicines that dissolve certain types of gallstones, but this only works for some stones and they can come back, so it is not right for everyone. Your doctor will explain which options suit you.

When is surgery considered?

Surgery to remove the gallbladder (called a cholecystectomy) is one of the most common operations performed. It is usually recommended if you have repeated bouts of pain from gallstones, an inflamed gallbladder, or a gallbladder that is not working properly and is causing clear symptoms. Most operations are done using keyhole surgery, which means several small cuts rather than one large one, and most people go home within a day or two. You can live a normal, healthy life without a gallbladder — your liver still makes bile and your body adjusts. If your scan shows no problem, surgery is usually not needed.

Living with this condition

Most people have a HIDA scan, get their results, and carry on with normal life within a day. If you are found to have a gallbladder problem, you may need to make some changes to how you eat while you wait for treatment. Many people find that eating a little and often, and going easy on very fatty meals, keeps symptoms manageable. If you have surgery, most people are back to normal activities within a couple of weeks, though you should follow your surgical team's advice about lifting and driving.

Lifestyle tips

• Eat regular meals rather than skipping meals, which can make bile build up in the gallbladder
• Choose grilled, baked, or steamed food more often than fried food
• Include fruit, vegetables, and whole grains in your day
• Stay active — aim for something you enjoy most days of the week
• Lose weight gradually if you and your doctor agree it would help, rather than very quickly
• Limit alcohol to within your country's recommended limits
• Get plenty of sleep and manage stress where you can — both affect how you feel day to day

Diet and exercise

There is no single 'gallbladder diet', but many people feel better when they eat less fat, especially fried and very rich foods, and eat smaller portions more often. Fibre from fruit, vegetables, and whole grains is helpful. Drink water through the day. Gentle, regular exercise — walking, swimming, cycling — supports healthy digestion and helps with weight management. If you are thinking about a big change in diet or a weight-loss plan, talk it through with your doctor or pharmacist first, because very rapid weight loss can itself cause gallstones.

Mental health and emotional wellbeing

Ongoing belly pain, nausea, and the uncertainty of waiting for tests can be stressful. It is very common to feel anxious before a scan or while waiting for results. Worry can also make pain feel worse, and pain can make sleep and mood harder. Be honest with your doctor about how you are feeling — emotionally as well as physically. Talking to friends, family, or a counsellor can help. If low mood or anxiety is affecting your daily life, or if you ever have thoughts of harming yourself, please reach out for crisis support straight away — contact your local emergency number or a mental health helpline in your country.

Prevention

You cannot prevent needing a HIDA scan, but you can lower your chances of gallbladder problems. The most helpful steps are keeping to a healthy weight, losing weight gradually rather than quickly, eating regular balanced meals with plenty of fibre, staying active, and limiting alcohol. If you already have gallstones that are not causing trouble, your doctor may simply keep an eye on them.

Screening programmes

There is no routine screening programme for gallbladder disease. Tests like a HIDA scan are arranged only when you have symptoms or when your doctor needs to check something specific. If you have a strong family history of gallstones or a condition that raises your risk, mention it to your doctor so they can advise you.

Complications

If left untreated

• If an underlying gallbladder problem is not looked into, symptoms such as pain and nausea can keep coming back and get in the way of eating, sleep, and work
• An inflamed gallbladder can become infected, which makes you more unwell and needs treatment quickly
• A stone stuck in a bile duct can cause jaundice, pale stools, dark urine, and pain
• Rarely, a blocked duct can lead to a serious infection of the bile system, which is a medical emergency
• Long-term inflammation can, in rare cases, cause other complications — this is why ongoing symptoms are worth checking
• Not having the scan itself carries no risk — the tracer is safe and leaves your body naturally

Long-term outlook

The outlook is generally very good. Most gallbladder problems are well understood and treatable, and most people recover fully. Many people have a normal HIDA scan and simply need another explanation for their symptoms, which your doctor can help you find. If surgery is needed, it is a common and safe operation, and most people are back to normal life within a few weeks. The important thing is to get symptoms checked rather than put them off — that way you can get the right answers and the right care.

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