Gallstones and Gallbladder Pain: Symptoms, Tests and When to Be Seen

What it involves

MedlinePlus defines gallstones as hard deposits that form inside the gallbladder, as small as a grain of sand or as large as a golf ball. The most common type is made of cholesterol, and MedlinePlus notes these stones are not related to your blood cholesterol level. The other main type is pigment stones, made of bilirubin.

Who this is for

• Patients with pain in the right upper or middle upper belly that lasts 30 minutes or more
• Patients with belly pain plus nausea, vomiting, or fever
• Patients with yellowing of the skin or eyes or clay-colored stools
• Patients with risk factors who want to know what the symptoms mean

What to expect

• Questions about where the pain is, how long it lasts, and what brings it on
• A belly exam and a review of risk factors, medicines, and recent weight changes
• Blood tests when appropriate, such as liver tests and a blood count
• A referral for ultrasound or other imaging and, if needed, for a surgeon

Many gallstones cause no symptoms

MedlinePlus says many people with gallstones have no symptoms at all, and the stones are often found during a routine x-ray, abdominal surgery, or another procedure. Trouble starts when a large stone blocks a tube that drains the gallbladder. That causes a cramping pain in the middle to right upper abdomen called biliary colic, and the pain goes away if the stone passes into the first part of the small intestine.

Symptoms that point to the gallbladder

MedlinePlus lists the symptoms that can occur:

• Pain in the right upper or middle upper abdomen for at least 30 minutes, constant or cramping, sharp or dull
• Fever
• Yellowing of the skin and whites of the eyes, called jaundice
• Clay-colored stools
• Nausea and vomiting

Who is more likely to get them

MedlinePlus says gallstones are more common in women, in Native Americans and people of Hispanic descent, in people over 40, in people who are overweight, and in people with a family history. Diabetes, birth control pills, pregnancy, liver cirrhosis, and rapid weight loss from a very low-calorie diet or weight loss surgery also raise the odds. If you are losing weight quickly, the unintentional weight loss guide explains what a provider looks for.

How it is checked

MedlinePlus says tests used to detect gallstones or gallbladder inflammation include an abdominal ultrasound and CT scan, among others. It also lists blood tests such as bilirubin, liver function tests, a complete blood count, and pancreatic enzymes. Blood work is a listed service here, and the liver function tests guide and complete blood count guide explain those two. Imaging is arranged through a referral, since the practice does not list it as a service.

When it becomes urgent

MedlinePlus says blockage by gallstones can cause swelling or infection in the gallbladder, in the tube that carries bile from the liver, or in the pancreas. It advises contacting your provider for pain in the upper abdomen or yellowing of the skin or whites of the eyes. Belly pain that is severe, comes with fever or repeated vomiting, or will not let you get comfortable should be seen the same day; the abdominal pain guide explains how location changes the picture.

Treatment, and what happens if there are no symptoms

MedlinePlus says surgery is usually not needed unless symptoms begin, and that people who have symptoms will generally need surgery soon after a stone is found. The common technique, laparoscopic cholecystectomy, uses small incisions. Medicines to dissolve cholesterol stones can take two years or longer and the stones may return. Surgery is done at a hospital by a surgeon, so a primary care visit is where the first workup and referral start.

Sources

• MedlinePlus — Gallstones
• MedlinePlus — Gallstones health topic