How to diagnose and identify gallstones

The diagnosis and differentiation of gallstones requires comprehensive judgment through symptom analysis, imaging examinations and laboratory tests, and differentiation from other diseases when necessary. Common symptoms of gallstones include sudden severe pain in the right upper abdomen, indigestion that worsens after eating, nausea and vomiting, etc., but the symptoms are not always typical, so accurate medical methods are needed to confirm the diagnosis.

Imaging examination is the most important method for diagnosing gallstones. Abdominal ultrasound examination is the first choice, which can clearly show the location and size of gallstones in the gallbladder and is non-invasive and safe. If the ultrasound results are unclear, further CT or MRI examinations can be performed. Especially when complex biliary diseases are suspected, magnetic resonance pancreaticobiliary imaging (MRCP) is a very effective supplementary means. Endoscopic ultrasound (EUS) also performs well in evaluating small stones or cholecystitis. Laboratory tests are used to evaluate complications such as infection or bile duct obstruction. Liver function indicators (such as increased bilirubin) and blood routine tests (increased white blood cells indicate infection) can be tested.

When differentiating gallstones, other diseases that cause abdominal pain, such as gastric ulcers, pancreatitis, or liver disease, should be excluded. Gastric ulcers can be diagnosed by gastroscopy, while pancreatitis is usually accompanied by significant elevations in serum amylase or lipase, and liver disease is diagnosed by liver ultrasound and virological indicators. Functional gallbladder disease and acalculous inflammation of the gallbladder may present similarly, but imaging and laboratory results can help differentiate them.

Once gallstones are diagnosed and symptoms are evident, treatment options are available based on the condition, such as extracorporeal shock wave lithotripsy, laparoscopic cholecystectomy, or endoscopic retrograde cholangiopancreatography (ERCP) stone removal. If the stones are asymptomatic, observation rather than surgery may be chosen based on risk assessment. Gallstone problems can be better managed by seeking medical attention promptly, following doctor's orders carefully, and undergoing regular checkups.