What are gallstones?
Gallstones are stones that are formed either in your gallbladder or the bile duct. The gallbladder is a small organ located just under the liver. Its basic function is to hold bile, which is a digestive fluid secreted by the liver. The gallbladder releases bile when it is required for digestion. Bile flows from the gallbladder through the bile duct and into the small intestine to burn fats. At times, the components contained in the bile crystallize leading to the formation of gallstones. The types of gallstones are classified according to their composition and they are cholesterol and pigment stones.
How are gallstones diagnosed?
Since gallstones sometimes do not show symptoms, they could be discovered when you are undergoing a test for a totally different problem. It is, however, wise to see your GP if you experience symptoms of gallstones to properly diagnose your condition.
An Appointment with Your GP
You will be asked by your GP to describe your symptoms in depth and to know if there is an inflammation of your gallbladder. A Murphy’s sign may be carried out. During the test, the doctor will place his hand or fingers on the upper right side of your abdomen and then will tell you to breathe. If you feel pain during the physical test, immediate treatment may be required.
To detect signs of infection or to determine whether your liver is functioning normally, blood tests may be recommended by your GP. Your liver will not work properly if gallstones have gone into the bile duct. In case the test and the symptoms suggest the presence of gallstones, further tests may be required. According to the severity of your symptoms, an immediate admission may be required.
An ultrasound is a machine that produces pictures of the internal parts of the body by the use of high-frequency sound waves. It can be used to detect gallstones. The ultrasound scan that is used during prenatal checkups is similar to the one used for gallstones. A transducer, a small device that can be held by the hand, is placed on your skin to scan your abdomen. The transducer sends sound waves via your skin into your body and then bounces back off the body tissues creating a picture on a monitor. The whole procedure lasts for about 10 to 15 minutes and is painless.
There could be doubts about the presence of gallstones in the bile duct after gallstones have been diagnosed. An ultrasound scan can sometimes detect gallstones in the bile duct. A cholangiography or an MRI scan can be conducted to detect the stones in the bile duct.
An MRI (magnetic resonance imaging) is used to detect gallstones that are present in the bile duct. To create detailed pictures inside the body, it uses radio waves and strong magnetic fields.
A cholangiography procedure gives more information about the gallbladder’s condition. A dye that is seen on X-rays is used in a cholangiography. The dye is introduced by the use of an endoscope that is passed via the mouth straight to the bile ducts while undergoing surgery or into your bloodstream.
X-ray pictures are then taken after the dye has been injected. Any abnormalities in the pancreatic system or in the bile can be shown. The dye is absorbed in the right places if your biliary system and gallbladder are found to be functioning normally.
By using an endoscope, the doctor at this point may attempt to remove the blockage that may have been seen during the test. This process is known as the endoscopic retrograde cholangiopancreatography (ERCP). For more information on ERCP, see the topic about treating gallstones.
Computed tomography is also known as a CT scan. This type of scan is performed to detect gallstone complications such as acute pancreatitis. Many X-rays are taken from various angles during a CT scan. They are performed in an emergency to know the cause of the patient's severe abdominal pain.
Liver Function Tests
The liver produces bile, which is stored in the gallbladder. Liver enzyme testing, which was formerly called as "liver function tests" are a group of blood tests that detect liver inflammation and damage. They can also check how well the liver functions. The liver test is usually done as part of a routine test. Your doctor may conduct a liver enzyme test if:
- You are on medication
- You have liver disease
- You have symptoms of bile disease (abdominal pain, yellow skin, and vomiting)
- If you consume alcohol in excessive amounts
HIDA (Hepatobiliary) Scan
A HIDA scan is a nuclear scanning test that checks to see how the gallbladder is functioning. The scan detects any blockage in the bile duct that connects the liver to the gallbladder and into the small intestine. During this scan, a radioactive tracer is injected into the veins of the arm. The liver then removes the tracer from the blood and adds it to the bile, which flows through the bile duct and to the gallbladder. The gallbladder then releases the tracer into the first part of the small intestine. A special camera is used to click pictures of the tracer as it moves through the liver, bile duct, gallbladder, and small intestine.
This scan is usually done to find out the cause of pain on the upper side of the abdomen and to detect any blockage in the bile duct or bile leak due to a previous surgery or injury. A HIDA scan may be similar to the gallbladder ultrasound test but is slightly different. This scan is done after an ultrasound and can also check how well the gallbladder is functioning. It can also find out the cause of jaundice.
Before your gallbladder test, tell your doctor if you are pregnant, if you are breastfeeding, whether you had an X-ray test four days before, or have taken a medicine that contains bismuth. Barium and bismuth can affect the test. Moreover, do not eat or drink 4 to 12 hours before your gallbladder scan.
Complete Blood Count
It is also good to do a complete blood count (CBC) so the levels of the different types of blood cells such as the white blood cells are checked. A high white blood cell count may indicate an infection.
Rapid Weight Loss and Gallstones
Rapid weight loss may make you susceptible to gallstone formation. If you lose three pounds or more in a week, you have high chances of developing gallstones compared to someone who gradually loses their weight. Certain methods of treating obesity such as VLCDs (very low-calorie diets) and weight loss surgery may put you at risk of developing gallstones since they promote rapid weight loss.
Weight loss surgery is a procedure done in the stomach to assist individuals in losing weight by regulating their intake of food or by affecting the digestion of food. VLCD is an extremely limiting diet that involves the use of a formula that is commercially prepared, which offers approximately 800 calories every day. These diets are closely monitored by a doctor.
Consult with your doctor on how to minimize your chances of developing gallstones before starting a VLCD or before undergoing a type of weight loss surgery.