Who is at risk for gallstones?
- women
- people over age 60
- Native Americans
- Mexican Americans
- overweight men and women
- people who fast or lose a lot of weight quickly
- pregnant women, women on hormone therapy, and women who use birth control pills
What are the symptoms?
Symptoms of gallstones are often called a gallstone "attack" because they occur suddenly. A typical attack can cause
- steady pain in the upper abdomen that increases rapidly and lasts from 30 minutes to several hours
- pain in the back between the shoulder blades
- pain under the right shoulder
- nausea or vomiting
Gallstone attacks often follow fatty meals, and they may occur during the night. Other gallstone symptoms include
- abdominal bloating
- recurring intolerance of fatty foods
- colic
- belching
- gas
- indigestion
People who also have the above and any of following symptoms should see a doctor right away:
- sweating
- chills
- low-grade fever
- yellowish color of the skin or whites of the eyes
- clay-colored stools
Many people with gallstones have no symptoms. These patients are said to be asymptomatic, and these stones are called "silent stones." They do not interfere in gallbladder, liver, or pancreas function and do not need treatment.
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 such as a pregnant uterus, 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. Ultrasound is the most sensitive and specific test for gallstones.
Other tests used in diagnosis include- Computed tomography (CT) scan may show the gallstones or complications.
- MR cholangiogram may diagnose blocked bile ducts.
- Cholescintigraphy (HIDA scan) is used to diagnose abnormal contraction of the gallbladder or obstruction. The patient is injected with a radioactive material that is taken up in the gallbladder, which is then stimulated to contract.
- 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 and remove 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.
