GALLSTONES DIAGNOSIS

Gallstones may be diagnosed by a family doctor, a specialist in digestive problems (a gastroenterologist), or a specialist in internal medicine. The doctor will first examine the patient's skin for signs of jaundice and feel (palpate) the abdomen for soreness or swelling. After the basic physical examination, the doctor will order blood counts or blood chemistry tests to detect evidence of bile duct obstruction and to rule out other illnesses that cause fever and pain, including stomach ulcers, appendicitis, and heart attacks.

More sophisticated procedures used to diagnose gallstones include:

Ultrasound imaging. Ultrasound has an accuracy rate of 96%.
Cholecystography (cholecystogram, gallbladder series, gallbladder x ray). This type of study shows how the gallbladder contracts after the patient has eaten a high-fat meal.
Fluoroscopy. This imaging technique allows the doctor to distinguish between jaundice caused by pancreatic cancer and jaundice caused by gallbladder or bile duct disorders.
Endoscopy (ERCP). ERCP uses a special dye to outline the pancreatic and common bile ducts and locate the position of the gallstones.
Radioisotopic scan. This technique reveals blockage of the cystic duct.