Gallstone Diagnosis

Gallstones are a digestive disorder characterized by hard deposits of digestive fluid that build up in the gallbladder. Your gallstone might be as small as a grain of sand or as large as golf ball. You may or may not have symptoms. It is not a serious condition but surgery might be necessary in some cases.

Diagnosing Gallstones

• If you suspect you have gallstones, your doctor will give you a computerized tomography (CT) scan to produce an image of your gallbladder; he can then check for the presence of stones.

  If your doctor wants to examine your bile ducts for possible blockage due to a gallstone, he might use one of the following tests: hepatobiliary iminodiacetic acid (HIDA) scan, magnetic resonance imaging (MRI) or endoscopic retrograde cholangiopancreatography (ERCP). If he discovers gallstones during the ERCP, they can be removed at that time.

  You might also receive a blood test to determine if any complications of gallstones are present like infections or jaundice.

Symptoms

• Many people can have gallstones with no symptoms. If one or more gets caught in a bile duct and forms a blockage, you might experience acute, escalating pain in the upper right quadrant of the abdomen and/or in the center of the abdomen right under the breastbone and pain between the shoulder blades and in the right shoulder. This pain can last from a few minutes to a few hours.

  Go to a doctor or hospital right away if your stomach pain is so intense you cannot sit still, if you experience yellowing of your skin or whites of the eyes or a high fever with chills. These may indicate a serious gallstone complication.

Causes

• You might get gallstones for three different reasons. If your bile contains too much cholesterol, it will form crystals that turn into stones over time. If your bile contains excessive amount of bilirubin, a chemical formed as the body breaks down red blood cells, it will form gallstones. Certain conditions like cirrhosis, biliary tract infections and blood disorders contribute to excess bilirubin. If your gallbladder does not empty sufficiently, bile accumulates and eventually forms a stone.

Risk Factors and Complications

• You are more likely to get gallstones if you are female, over 60, American Indian or Mexican-American, overweight, pregnant, eat a low-fiber, high-fat, or high-cholesterol diet, take medications that lower cholesterol or contain estrogen, or have a family history of the condition.

  Complications include inflammation of the gallbladder, blockage of bile ducts resulting in jaundice or infection, blockage of the pancreatic duct leading to pancreatitis, and an increased risk of gallbladder cancer. Gallbladder cancer is very rare.

Treatment

• If your doctor discovers gallstones which are not causing problems, such as during a scan for an unrelated condition, you probably will not require treatment. You should be on the lookout for symptoms and seek treatment if needed in the future.

  If your gallstones are causing symptoms, you might need your gallbladder removed as gallstones frequently recur. Your gallbladder is not essential for living and your digestive processes will not be affected. If you are not a candidate for surgery, you can take medication to dissolve the stones but this can take months or even years. A current experimental treatment involves injecting medication directly into the stone.

Prevention

• Skipping meals and fasting can increase the chances of developing gallstones. Try to exercise at least 30 minutes a day and if you are trying to lose weight, do it slowly; shoot for 1 to 2 lbs. a week. Maintaining a healthy weight reduces your risk. Eat a high-fiber diet low in fat and cholesterol.