Generally, gallstones do not prompt symptoms. However, if one becomes lodged in a duct and causes blockage, these symptoms may appear:1
• Sudden and rapidly intensifying pain in the upper right part of the abdomen, and/or in the center of your abdomen, just below the breastbone
• Back pain between the shoulder blades
• Pain in the right shoulder
• Nausea or vomiting
Gallstone-related pain may last for several minutes up to a few hours. You should consult a physician immediately if you notice any of the aforementioned symptoms, but most especially if these conditions appear:
• A high fever with chills
• Yellowing of the skin and the whites of the eyes
• Intense abdominal pain that prevents the patient from sitting still or finding a comfortable position
Some gallstone symptoms can be similar to conditions such as appendicitis, ulcers, pancreatitis and gastroesophageal reflux disease. In certain cases, “silent gallstones” may be found even if a patient does not have indicators. Case in point: A health care provider may notice gallstones while performing an ultrasound for another reason.2
Diagnostic Methods for Gallstones
• Ultrasound: A device called a transducer bounces safe and painless sound waves off organs to develop an image of their structure. An ultrasound can be done by a specially trained technician, either in a health care provider's office, outpatient center or hospital.
A radiologist (a doctor specializing in medical imaging) inspects these results. A major advantage of an ultrasound is its high accuracy in searching for gallstones, since the stones will be visible in the image.
• Computerized tomography (CT) scan: This type of procedure produces three-dimensional images of the body, using X-rays and an injection of a special dye called the contrast medium.
Just like with an ultrasound, anesthesia isn’t needed. Results of a CT scan may show gallstones, and/or complications like an infection and blockage of the gallbladder or bile ducts. Unfortunately, there are instances wherein CT scans might miss undetected gallstones that may be present in your body.
• Magnetic resonance imaging (MRI): MRIs can show gallstones lodged in the ducts of the biliary system. MRI machines use radio waves and magnets to develop detailed pictures of the body's internal organs and soft tissues. While MRIs don’t require anesthesia, a person with a fear of confined spaces may be lightly sedated.
• Cholescintigraphy: Also called a hydroxyl iminodiacetic acid scan, HIDA scan or hepatobiliary scan, cholescintigraphy produces pictures of the biliary system. This procedure doesn’t require anesthesia, and is often used for diagnosing abnormal contractions of the gallbladder or obstruction of the bile ducts.
A health care provider injects a small amount of radioactive but harmless dye into a vein in the patient’s arm. A special camera takes pictures of the radioactive material as it moves through the body’s biliary system. A substance that prompts the gallbladder to contract may also be injected.
• Endoscopic retrograde cholangiopancreatography (ERCP): In this method, an X-ray is used to look into the bile and pancreatic ducts. Prior to an ERCP, a patient is lightly sedated.
An endoscope, a small and flexible tube with a light and a camera at the end, is inserted through the mouth, and into the duodenum and bile ducts. The health care provider injects contrast medium via a tube into the patient’s bile ducts, so these organs can be visible to a computer and a monitor that are attached to the endoscope.
This test locates the affected bile duct and gallstone, and a blocked stone may be removed and captured onto a tiny basket attached to the endoscope. However, an ERCP tends to be more invasive compared to other tests, and is only used selectively.
Other Considerations When Checking for Gallstones
Apart from the aforementioned diagnostic tests used to check for gallstones, your physician may also recommend that you undergo a blood test to search for signs of infection or inflammation of the bile ducts, gallbladder, pancreas or liver.4