Gallstones can be symptomatic (cause symptoms) or asymptomatic (without symptoms). Asymptomatic stones are discovered when the person is being investigated for some other condition, such as an ultrasound test during pregnancy or routine health check-up. If you have symptoms suggestive of gallbladder disease your doctor will take a detailed medical history about your symptoms and do a physical exam. If your medical history and physical exam is suggestive of gallstones, tests are done to confirm the diagnosis. Some tests done to confirm the diagnosis include:
Abdominal ultrasound: This is a painless and non-invasive test. High-frequency sound waves are used in ultrasound to produce a picture of the inside of your body. During abdominal ultrasound a trained doctor can look at the images that are formed and detect normal and abnormal structures. It can help to detect many conditions of the abdomen including gallstones, hepatitis and other serious conditions like pancreatic cancer. The test can show the location of the gallstone, and other problems with the gallbladder or bile ducts. In many people this test can confirm gallstones and further tests may not be needed.
Gallbladder scan: If no abnormality is detected on abdominal ultrasound, but your symptoms are suggestive of gallbladder disease then your doctor may recommend gallbladder scan. In this test, a special radioactive dye is injected in the vein (most commonly in a vein the arm). After this a series of pictures are taken to assess if the gallbladder is working normally. This test is useful to diagnose many problems of the gallbladder including gallstones, blocked bile ducts (bile ducts are tubes attached to your gallbladder).
Endoscopic retrograde cholangiopancreatogram (ERCP): If a stone is suspected in one of the ducts that connects your liver with your gallbladder, gallbladder with small intestine or pancreatic duct then ERCP may be done. In this test a flexible, lighted instrument called an endoscope is inserted down the throat and through your stomach to examine the ducts that carry bile from the liver to the small intestine (the hepatic duct, cystic duct, common bile duct) and pancreatic duct. In some cases if a gallstone is visualised in the duct system it may be possible to remove it with instruments inserted through the endoscope.
Blood tests: The doctor may recommend certain tests such as a complete blood count, tests for liver function and pancreatitis. These are often helpful to evaluate if abdominal pain and other symptoms are caused because of gallstones or some other condition.
Endoscopic ultrasound (EUS): An endoscope is inserted with an ultrasound probe down the throat and through your stomach to examine the ducts that carry bile from the liver to the small intestine (the hepatic duct, cystic duct, common bile duct) and pancreatic duct.
Magnetic resonance cholangiogram (MRC): Magnetic field and pulses of radio wave energy (MRI) are used in this test to create images of organs and structures inside abdomen. MRC can help to detect gallstones or problems with the bile duct or gallbladder.