How Doctors Diagnose Gallstones

Medically Reviewed By William C. Lloyd III, MD, FACS
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Your gallbladder plays a dutiful role in your digestive process. It stores bile made by the liver and then secretes it after you eat to help the body digest fats. But what happens when the gallbladder develops hard particles called gallstones? How do you know if you have them? Gallstones can be diagnosed in a number of ways. 


By Chance

It may surprise you to know that gallstones are often diagnosed completely by accident. That’s because they usually cause no symptoms and don’t get in the way of normal gallbladder function. As a result, many people live with the stones and don’t even know it. In this case, gallstones may be diagnosed only if the stones are found during an X-ray or ultrasound performed for another reason. 

Following a Gallbladder Attack

Gallstones make themselves known if they block the bile ducts, a situation called a gallbladder attack. If a blockage occurs, you may experience sudden symptoms like chest pain, pain in the upper abdomen that radiates to the right shoulder, nausea, sweating, and vomiting

If you experience these symptoms, call your doctor right away. This is important even if your symptoms go away, which can happen if the stone moves away from the duct. A gallbladder attack can mimic other conditions, such as appendicitis, ulcers, pancreatitis, reflux disease, and even a heart attack. Your doctor will likely ask you questions about your symptoms and location of pain

If your doctor suspects a gallbladder attack, you’ll likely have an imaging test like an ultrasound. These tests provide important information, such as the location and size of the stones as well as how they affect organ function. 

Ultrasound

The most accurate and frequently used test to diagnose gallstones is also one of the simplest to administer: the abdominal ultrasound. This quick, noninvasive test involves the use of a handheld probe called a transducer, which is moved over the abdomen. The device bounces sound waves off abdominal organs to create an image of their structure on a computer screen. If you have gallstones, they will show up on the image. 

Other Testing

Your doctor may use other imaging tests to diagnose gallstones or gallstone-related problems.

A CT ( computerized tomography) scan is a series of X-rays that creates detailed pictures of the inside of the body. CT scans may be helpful in showing complications of gallstones, such as infection or blockage of the bile duct. 

Magnetic resonance cholangiopancreatography (MRCP) is an MRI test that uses radio waves and magnets to produce detailed pictures of the liver, gallbladder, bile ducts, pancreas, and pancreatic duct. It can show gallstones, as well as the inflammation or blockage they may cause.  

If you have gallstones and they are causing symptoms, then your doctor may discuss treatment, such as surgery to remove your gallbladder. Without a gallbladder, you still produce bile to help with digestion. But, it may take longer for your body to digest food, particularly fatty foods.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 May 6
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