General and Gastrointestinal Surgery

About Gallstones

How are gallstones diagnosed?

Gallstones are diagnosed by various radiological studies.  

  • The first and most common test is an ultrasound, which uses sound waves to determine if stones are present. This test has no pain associated with it and is not invasive. The technician places jelly on the patient's abdomen and slides a wand across it. The wand emits a sound wave which bounces back to the wand and ultimately to a computer, which produces a picture.
  • Another test is an oral cholecystogram (OCG).  For this test the patient takes 8 pills the night before the x-ray is taken. The x-ray is taken the next day. The pills dissolve, are absorbed and then excreted into the bile to form a dye that outlines the gallbladder, giving an image which can be seen on the x-ray. The image may be normal or may show stones. If no image shows up, the patient either did not absorb the pills or the gallbladder does not work. In this case, the patient is asked to take the pills again and repeat the x-ray. If there is still no picture, the gallbladder is diseased.

These tests are usually done because you are having symptoms that are consistent with gallstones or your doctor is looking for another problem, such as an ovarian cyst.

What are gallstones?

Gallstones or cholelithiasis are collections of sediment in the bile which form a solid structure not unlike a marble or stone. Most of them are soft and can be easily crushed into powder. They are collections of either cholesterol and or calcium-bilirubin. The vast majority (80%) are principally composed of cholesterol but only a small number (10%) are pure cholesterol. These stones are yellow or brown. Calcium bilirubinate stones are black and usually much harder than the cholesterol stones. They comprise about 20% of gallbladder stones. Gallstones vary in size from tiny grains like salt to large 1 to 2 inch diameter rocks.

Is the cholesterol level in my blood related to gallstones?

No. There is no known relationship between cholesterol in the blood and the formation of gallstones. However it is important to recognize that measures taken to lower cholesterol such as dieting and cholesterol lowering drugs can lead to gallstone formation.

Will my cholesterol change if my gallbladder is removed?

Not directly. If your diet does not change after your gallbladder is removed, there will be no change in your blood cholesterol level. However, patients who have gallbladder symptoms may be unconsciously avoiding fats and cholesterol rich foods. After your gallbladder is removed you will no longer have symptoms, which may lead to a diet that is higher in fats and cholesterol. This may, in turn, lead to an elevated cholesterol level.

Learn about symptoms

 More about the gallbladder and gallstones