Bile Sludge

Many patients with right-sided fibromyalgia, shoulder pain, or arm pain actually have a gallbladder problem rather than a musculoskeletal one. TUDCA is recommended as a bile salt taken on an empty stomach — two capsules in the morning and two in the afternoon. Bile sludge is a precursor stage before a gallstone fully forms. Bile duct congestion can generate referred pain along the entire right side of the body, including the shoulder, neck, arm, and hip. Gallbladder sludge is thickened bile that backs up the ductal system, creating pressure and referred pain at the rib-cartilage junction. Thinning bile sludge and restoring proper ductal drainage is the primary goal of treatment for biliary-related costochondritis.