Diagnosing Gallstones

NHS

Gallstones may be discovered during tests for a different condition, as they often don't cause any symptoms. If you have symptoms of gallstones, make an appointment with a GP so they can try to identify the problem.

Seeing a GP

The GP will ask about your symptoms in detail and may carry out the Murphy's sign test to help determine if your gallbladder is inflamed. During this test, the GP places their hand or fingers on the upper-right area of your tummy and asks you to breathe in.

If you find this painful, it usually means your gallbladder is inflamed and you may need urgent treatment. Your GP may also recommend having blood tests to look for signs of infection or check if your liver is working normally.  If gallstones have moved into your bile duct, the liver may not be able to function properly.

Further tests

If your symptoms and test results suggest you may have gallstones, you'll usually be referred for further tests. You may be admitted to hospital for tests the same day if it's thought you may have a more severe form of gallbladder disease.

Ultrasound scan

Gallstones can usually be confirmed using an ultrasound scan, which uses high-frequency sound waves to create an image of the inside of the body. The type of ultrasound scan used for gallstones is similar to the scan used during pregnancy, where a small handheld device called a transducer is placed onto your skin and moved over your upper abdomen.

Sound waves are sent from the transducer, through your skin and into your body. They bounce back off the body tissues, forming an image on a monitor. This is a painless procedure that usually takes about 10 to 15 minutes to complete.

When gallstones are diagnosed, there may be some uncertainty about whether any stones have passed into the bile duct. Gallstones in the bile duct are sometimes seen during an ultrasound scan. If they're not visible but your tests suggest the bile duct may be affected, you may need an MRI scan or a cholangiography.

MRI scan

An MRI scan may be carried out to look for gallstones in the bile ducts. This type of scan uses strong magnetic fields and radio waves to produce detailed images of the inside of the body.

Cholangiography

A procedure called a cholangiography can give further information about the condition of your gallbladder. A cholangiography uses a dye that shows up on X-rays. The dye may be injected into your bloodstream or directly into your bile ducts during surgery, or by using an endoscope passed through your mouth.

After the dye has been introduced, X-ray images are taken. They'll reveal any abnormality in your bile or pancreatic systems. If your gallbladder and bile systems are working normally, the dye will be absorbed in the places it's meant to go (your liver, bile ducts, intestines and gallbladder).

If a blockage is detected during this test, your doctor may try to remove it at this point using an endoscope. This is known as an endoscopic retrograde cholangio-pancreatography (ERCP).

CT scan

A CT scan may be carried out to look for any complications of gallstones, such as acute pancreatitis. In this type of scan, a series of X-rays are taken from many different angles. CT scans are often carried out in an emergency to diagnose severe abdominal pain.

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