How Gallstones Are Diagnosed?


Gallstones: The gallbladder is an organ that stores and releases digestive juice called bile. It is produced from the liver to digest the food and helps in breaking fats into fatty acids. Bile also carries out waste products like cholesterol and bilirubin [a chemical that is created when old red blood cells are destroyed].

If there is any liver problem it can cause excessive secretion of bile and can lead to the formation of gallstones. Gallstones are hard clusters of cholesterol or bilirubin. They can grow in size when bile washes over them.

Diagnosis of gallstones:

In a few cases even if you have gallstones they do not show any noticeable signs or symptoms. Sometimes gallstones can cause symptoms like fever, vomiting, diarrhea, severe & sharp pain in the upper right side of the abdomen, and pain in the upper right shoulder or between the shoulder blades. etc. If gallstones are treated in time, they can block the gallbladder duct and pancreatic duct leading to cholecystitis [inflammation of gallbladder] and pancreatitis [inflammation in pancreas]. Once you start noticing the signs and symptoms of gallstones, consult with your doctor, and plan an appropriate course of treatment.

As gallstone disease can develop in many different ways, your doctor can suggest undergoing several tests to evaluate and to diagnose the gallstones. Below we have mentioned how your doctor can diagnose gallstones.

List of questionnaires by your doctor:

After noticing the symptoms of gallstones you should consult your doctor. During the consultation with your doctor or general practitioner, he/she can ask about your symptoms in detail like “from when did the symptoms start showing”, “what are the symptoms you are suffering from”, “is your abdominal pain is severe and at what location”, and “what food items do you eat regularly”, etc.

  • Murphy’s sign test:

Sometimes your doctor can carry out Murphy’s sign test to help determine if your gallbladder is inflamed. During Murphy’s sign test, your doctor places their hand or fingers on the upper-right area of your tummy and asks you to deep breathe in and hold. If the gallbladder comes into contact with the doctor’s hand, Murphy’s sign test is positive which means your gallbladder is inflamed and requires urgent treatment.

  • Endoscopy:

Endoscopy is a diagnostic procedure where your doctor will insert a thin and flexible tube that has a light at one end into your mouth. Once it is inserted in your mouth, your doctor will guide it down through your throat, stomach, and small intestine to visualize and examine the biliary system.

  • Abdominal computed tomography:

This test uses X-rays to construct and produce detailed images of abdominal organs like the gallbladder, liver, pancreas, and bile ducts. It also provides information like blockage to the flow of bile and whether liver or bile ducts are affected by gallstones or not.

  • Ultrasound:

Abdominal Ultrasound is the gold-standard test to look for gallstones as it is simple and non-invasive. This abdominal ultrasounds test is commonly used to evaluate the abnormalities of the gallbladder. This test uses sound waves to take images of the gallbladder and bile ducts.

Ultrasound helps in showing signs of inflammation of the gallbladder [cholecystitis] and indications of blockage for bile flow. If gallstones are blocking the movement of bile, an ultrasound might show widened bile ducts.

  • Liver function tests [LFTs]:

Liver function tests are also known as a liver panel. LFTs help in measuring different enzymes and proteins made by the liver such as albumin, bilirubin, total protein, alkaline phosphatase [ALT], lactate dehydrogenase [LD], and aspartate aminotransferase [AST]. This test checks the overall health of your liver and helps in the diagnosis of liver inflammation. Once inflammation of the liver is diagnosed, your doctor may perform other blood tests to know whether the inflammation is caused by gallstones or not.

  • Complete blood count [CBC]:

The complete blood count is a group of tests that evaluate the levels of red blood cells [RBCs], white blood cells [WBCs], platelets [PLTs], packed cell volume [PCV], mean platelet volume [MPV], and hematocrit [HCT], etc. CBC helps in evaluating your overall health condition and detects a wide range of diseases and conditions such as infections, anemia, and leukemia, etc.

If gallstones cause inflammation, levels of WBCs can be elevated or higher. In such cases, your doctor can recommend a few other blood tests to look for signs of infection. To check any injury to the liver or pancreas, your doctor can suggest a few blood tests like liver function tests [LFTs]. Blood tests can help in revealing the presence of jaundice, infection, inflammation of the gallbladder, pancreatitis, or other complications caused by gallstones.

  • Hydroxy iminodiacetic acid [HIDA] scan:

This is also called Cholescintigraphy or hepatobiliary scintigraphy. It is an imaging test that involves injecting a radioactive material called hydroxy iminodiacetic acid [HIDA] into your vein. Then HIDA travels through the bloodstream into the hepatobiliary tract, gallbladder, and bile ducts. Once it reaches, it shows how they function.

This test is useful when ultrasound results are inconclusive. This test helps in finding out the blockage of the gallbladder and acute inflammation of the gallbladder as well.

  • Magnetic resonance cholangiopancreatography [MRCP]:

MRCP uses magnetic resonance imaging [MRI] to produce detailed images of the liver, gallbladder, bile ducts, pancreas, and pancreatic duct. This test helps in identifying the gallstones that have escaped from the gallbladder and are blocking the bile duct. MRCP also shows inflammation of both the gallbladder and pancreas.

  • Endoscopic retrograde cholangiopancreatography [ERCP]:

ERCP is a procedure where a tube is placed into the small intestine through your throat and the stomach. Then a dye can be injected into the tube and uses X-rays to visualize the ducts of the gallbladder, liver, and pancreas. ERCP helps in the diagnosis of inflammation of the pancreas [pancreatitis], gallbladder inflammation [cholecystitis], infection of bile [cholangitis], and blockage of bile ducts due to gallstones.


If you notice any of the symptoms of gallstones, consult your doctor immediately, and get diagnosed. Your doctor can use blood tests and imaging tests like CTC, liver function test, ultrasound, CT scan, MRCP, and ERCP to evaluate and to diagnose the gallstones along with the medical conditions caused by gallstones. Blood tests are majorly used to identify the infection and inflammation of the liver, gallbladder, pancreas, and bile ducts. Imaging tests can be used to provide valuable information about the location, size, and effect of gallstones on the function of different organs.

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