How are gallstones diagnosed?

Dr. Lisa Ganjhu, DO

Pain and bloating are two tips-offs of a possible gallstone problem—but what then? Check out this video with Dr. Lisa Ganjhu, a gastroenterologist, to learn about diagnostic tests and treatment options for gallstones.

To diagnose gallstones, your doctor may decide to take pictures of your gallbladder using ultrasound or a CT scan. Scans, magnetic resonant imaging (MRI) and other tests also can show whether a gallstone is blocking your bile duct. Your doctor may also take a blood test to look for signs of serious complications, like jaundice, an infection or pancreatitis.

Frequently, gallstones are discovered during tests for other health conditions. When gallstones are suspected, the doctor is likely to do an ultrasound exam—the most sensitive and specific test for gallstones. A handheld device, which a technician glides over the abdomen, sends sound waves toward the gallbladder. The sound waves bounce off the gallbladder and other organs, and their echoes make electrical impulses that create a picture of the gallbladder on a video monitor. If gallstones are present, the sound waves will bounce off them, too, showing their location. Other tests are as follows:

Computerized tomography (CT) scan: The CT scan is a non-invasive x-ray that produces cross-section images of the body. The test may show the gallstones or complications, such as infection and rupture of the gallbladder or bile ducts.

Cholescintigraphy (HIDA scan): The patient is injected with a small amount of non-harmful radioactive material that is absorbed by the gallbladder, which is then stimulated to contract. The test is used to diagnose abnormal contraction of the gallbladder or obstruction of the bile ducts.

Endoscopic retrograde cholangiopancreatography (ERCP): ERCP is used to locate and remove stones in the bile ducts. After lightly sedating you, the doctor inserts an endoscope—a long, flexible, lighted tube with a camera—down the throat and through the stomach and into the small intestine. The doctor guides the endoscope and injects a special dye that helps the bile ducts appear better on a video monitor. The endoscope helps the doctor locate the gallstone. The stone is captured in a tiny basket and removed with the endoscope.

Blood tests: Blood tests may show signs of infection, obstruction, pancreatitis or jaundice.

Since gallstone symptoms may be similar to those of a heart attack, appendicitis, ulcers, irritable bowel syndrome, hiatal hernia, pancreatitis and hepatitis, an accurate diagnosis is important.

This answer is based on source information from National Institute of Diabetes and Digestive and Kidney Diseases.

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The best test for evaluating most gallbladder problems is an ultrasound. Gallstones may also be seen on computed tomography (CT) scans and magnetic resonance imaging (MRIs); sometimes they can also be seen on x-rays. Your primary care provider can direct you as to the best option to begin treatment.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.