Gallstones: Diagnosis and Treatment

Diagnosis

• A medical history and a physical examination are the first steps.
  
• Blood testing is usually performed.
  
• An ultrasound of the abdomen will directly show gallstones, if present.
  
• Endoscopic retrograde cholangiopancreatography (ERCP) or magnetic resonance cholangiopancreatography (MRCP) can be used to check for gallstones that may traveled from the gallbladder into the bile ducts. ERCP can also extract stones when they are found, avoiding the need for surgery.

Treatment

• Asymptomatic gallstones generally do not need to be treated.
  
• It is important to avoid fatty foods and other dietary triggers (see Nutritional Considerations).
  
• If symptoms occur, surgery to remove the gallbladder is the treatment of choice.
  
• Patients who are not surgical candidates have two options: Lithotripsy can be used to break up stones, and medications can be used to dissolve small stones and stone fragments. However, these therapies are not as effective as surgery.