Asymptomatic gallstones
Gallstones are often discovered by chance during investigations of unrelated conditions. They are commonly detected during:
- blood tests
- cholesterol tests
- ultrasound scans
Occasionally, gallstones are detected during X-rays.
Symptomatic gallstones
When you visit your GP with symptoms of gallstones, your GP will ask you about the pattern of your symptoms so that they can assess whether you may have complicated gallstone disease.
For example, they will want to know whether you have experienced a high temperature of 38C (100.4F) or above, a rapid heartbeat and jaundice.
They may also carry out a simple test known as the Murphy’s sign test. You breathe in and your GP gently taps your abdomen near the location of your gallbladder. If the tapping causes pain, it usually indicates that your gallbladder is inflamed.
A diagnosis of gallstones can be confirmed using an ultrasound scan. You may also be given a liver function test. This is a type of blood test that is used to assess the state of your liver. The test is used because, if gallstones have moved into your bile duct, the normal functioning of your liver will be disrupted.
If your symptoms suggest that you have uncomplicated gallstone disease, you will be given a referral for a routine ultrasound.
If your symptoms suggest that you have complicated gallstone disease, you may be admitted to hospital so that an ultrasound can be carried out as soon as possible.
Cholangiography
Once a diagnosis of gallstones has been confirmed, you may have a procedure called a cholangiography to obtain further information about the gallstones and the condition of your gallbladder.
A cholangiography uses a dye that shows up on X-rays. The dye will either be injected into your bloodstream so that it concentrates in your bile ducts and gallbladder, or inserted into your bile ducts using a flexible, fibre-optic camera (endoscope). This procedure is called endoscopic retrograde cholangiopancreatolography (ERCP).
After the dye has been introduced, X-ray images are taken. The X-rays will reveal any abnormality in your bile or pancreatic systems, such as an inflamed gallbladder or pancreas. If your gallbladder and bile systems are working normally, the dye will be absorbed through all the places that bile is meant to go (your liver, bile ducts, intestines and gallbladder).
If the dye does not appear in one or more of these places, it usually signifies that gallstones are causing an obstruction. By studying the X-ray images, the precise location of the gallstones can be identified.
