How are gallstones diagnosed?

Many gallstones, especially silent stones, are discovered by accident during tests for other problems. But when gallstones are suspected to be the cause of symptoms, the doctor is likely to do an ultrasound exam. Ultrasound uses sound waves to create images of organs. Sound waves are sent toward the gallbladder through a handheld device that a technician glides over the abdomen. The sound waves bounce off the gallbladder, liver, and other organs, and their echoes make electrical impulses that create a picture of the organ on a video monitor. If stones are present, the sound waves will bounce off them, too, showing their location.

Other tests used in diagnosis include

• Cholecystogram or cholescintigraphy.

  The patient is injected with a special iodine dye, and x-rays are taken of the gallbladder over a period of time. (Some people swallow iodine pills the night before the x-ray.) The test shows the movement of the gallbladder and any obstruction of the cystic duct.

• Endoscopic retrograde cholangiopancreatography (ERCP).

  The patient swallows an endoscope a long, flexible, lighted tube connected to a computer and TV monitor. The doctor guides the endoscope through the stomach and into the small intestine. The doctor then injects a special dye that temporarily stains the ducts in the biliary system. ERCP is used to locate stones in the ducts.

• Blood tests.

  Blood tests may be used to look for signs of infection, obstruction, pancreatitis, or jaundice.

Gallstone symptoms are similar to those of heart attack, appendicitis, ulcers, irritable bowel syndrome, hiatal hernia, pancreatitis, and hepatitis. So accurate diagnosis is important.

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Reprinted from the National Digestive Diseases Information Clearinghouse (NDDIC)