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A lot of other conditions can cause symptoms like the ones you get with gallstones. Your doctor will examine you and may do some tests to work out what is causing your symptoms.

Here are some things your doctor will do to help tell if you have gallstones.¹

First, your doctor will ask you questions about the pain:

• Where does it hurt?
• How bad is it?
• How fast does it come on?
• How long does it last?
• Does anything bring it on?
• Does anything make it go away?

Your doctor will also want to know if you've felt sick to your stomach or thrown up, and any other symptoms you have during an attack.

Then you will probably have a physical examination. Your doctor may:

• Look at your abdomen to see if it's stiff or bloated
• Feel your abdomen to see if it is sore
• Take your temperature to see if you have a fever
• Listen to your abdomen with a stethoscope to see if your bowel is making more or less noise than is normal.

If your doctor thinks that gallstones may be causing your symptoms, he or she may send you for tests.

Or you may be sent to a doctor who specializes in digestive problems. This may be a doctor called a gastroenterologist. The specialist can set up your tests and see you for any care you need afterwards.

If your doctor thinks your gallstones are causing inflammation of your gallbladder or another problem, you will probably have to go to the hospital right away.

The best test for gallstones is an ultrasound scan.^{2 3} This test uses sound waves to make a picture of your insides. It doesn't hurt.

Your doctor or a scanning specialist uses a tool that looks a bit like a microphone. He or she puts it on your abdomen. It sends out and picks up sound waves.

The ultrasound machine turns the sound waves into a picture. The picture shows up on a screen.

If you have stones in your gallbladder or in any of the tubes (ducts) that carry bile, the stones usually show up in the picture. But very small ones may not show up.

Finding gallstones on your scan doesn't always mean they are the cause of your symptoms. But it will help your doctor work out what is the cause.

For blood tests, a small amount of blood is taken from your arm. Then it is sent to a laboratory.

These tests don't directly tell if you have gallstones. But they can pick up some of the problems that gallstones can cause.

For example, these tests can show if:

• Your liver isn't working properly
• You have an infection
• You have waste products building up in your body (called jaundice)
• Your pancreas isn't working properly.

Gallstones don't show up on a regular X-ray of your abdomen. But your doctor may suggest you have one to check for other things that might be causing your symptoms.

The X-ray doesn't hurt. You just lie on your back on a table and hold your breath while the picture is taken. You may need to move or stand up for more pictures.

Your doctor may suggest a special X-ray called an oral cholecystogram. For this test, you take some pills ahead of time. They make your bile show up on X-rays.

If your doctor thinks you might have gallstones that are causing problems, he or she may suggest some extra tests. For more, see Other tests for gallstones.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.