Diagnosis

What is biliary colic?

Biliary colic is a pain that is felt in the top of the stomach, either in the middle or just under the ribs on the right hand side. It is usually a continuous pain but may come in waves. It is usually rather more severe than 'indigestion' and it is not uncommon for patients to feel so uncomfortable that they may seek medical advice. The pain usually lasts for a few hours and then goes away. Occasionally patients may feel sick or may vomit. The pain often follows a meal and may be noticed most often in the evenings – but one of the most irritating features of biliary colic is that it may occur at any time.

What is jaundice?

Jaundice (sometimes called yellow jaundice) is caused because the body is unable to get rid of bilirubin, which is a yellow chemical that occurs normally in the body. Bilirubin comes from red blood cells that have reached the end of their natural life, and it is one of the body's waste products that the liver has to deal with. The liver gets rid of bilirubin by mixing it in with bile. So, if a gallstone blocks the main duct leading from the liver into the intestine, bilirubin can't get out of the body and a yellow colour can be seen in the eyes and the skin. Some of the pigment does escape in the urine making it look a very dark colour.

What might make my doctor suspect that I have gallstones?

Your doctor might suspect gallstones if you have been getting pains anywhere round the top of your abdomen, particularly if these have been lasting for only a short time and coming occasionally. If you develop jaundice as well, your doctor would feel that it was very probable that you had gallstones. Your doctor would examine you to see if there was any soreness in the top of your abdomen, which is often the case, and might look at the whites of your eyes to see if there is any sign of jaundice.

What tests might I have?

Your doctor would probably arrange for you to have some blood tests to look for signs of inflammation or jaundice. The best test for gallstones is an ultrasound scan. This is a very easy scan to have, as a little probe is moved over the upper abdomen in the region of the liver and gall bladder, and usually it is very easy to pick out gallstones on the screen. Gallstones reflect ultrasound very well and are easily detected, unless they are deep in the abdomen or hidden behind some gas in the intestine. If the ultrasound scan does not give a clear result then other tests may be needed. Fortunately there are a number of different ways of scanning the gallbladder that enable doctors to say with confidence whether or not you have gallstones.