The exam may involve using diagnostic tests that help your doctor see inside your body. These tests include:

Ultrasound: An ultrasound produces images of your abdomen. It’s the preferred imaging method to confirm that you have gallstone disease. It can also show abnormalities associated with acute cholecystitis.

Abdominal CT scan: This imaging test takes pictures of your liver and abdominal region.

Gallbladder radionuclide scan: This important scan takes about one hour to complete. A specialist injects a radioactive substance into your veins. The substance travels through your blood to the liver and gallbladder. On a scan, it can reveal evidence to suggest infection or blockage of the bile ducts from stones.

Blood tests: Your doctor may order blood tests that measure the amount of bilirubin in your blood. The tests also help determine how well your liver is functioning.

Endoscopic retrograde cholangiopancreatography (ERCP): ERCP is a procedure that uses a camera and X-rays to look at problems in the bile and pancreatic ducts. It helps your doctor look for gallstones stuck in your bile duct.

According to Harvard Health Publications, 80 percent of gallstones are made of cholesterol. The other 20 percent of gallstones are made of calcium salts and bilirubin.

It’s not known exactly what causes gallstones to form, though there are some theories.

Too much cholesterol in your bile

Having too much cholesterol in your bile can lead to yellow cholesterol stones. These hard stones may develop if your liver makes more cholesterol than your bile can dissolve.

Too much bilirubin in your bile

Bilirubin is a chemical produced when your liver destroys old red blood cells. Some conditions, such as liver damage and certain blood disorders, cause your liver to produce more bilirubin than it should. Pigment gallstones form when your gallbladder can’t break down the excess bilirubin. These hard stones are often dark brown or black.

Concentrated bile due to a full gallbladder

Your gallbladder needs to empty its bile to be healthy and to function properly. If it fails to empty its bile content, the bile becomes overly concentrated, which causes stones to form.

The most common sign of a gallbladder attack is pain in the upper right abdomen, just under the rib cage. Pain may also be felt in the upper center of the belly, or in the lower chest.

Gallstones themselves are not usually serious. In some cases people have no symptoms. But in rare cases they can result in serious problems, such as:

• Gallbladder infection
• Inflammation of the pancreas
• Jaundice (yellowish skin and eyes)
• Blockage of the bile ducts and liver
• Tears in the gallbladder, which can be fatal

Medications may help break up the gallstones while keeping the gallbladder. Medications are only effective on some types of gallstones, and they can take a long time to work. Shock wave therapy can also be used to help break up the stones while preserving the gallbladder. Stones often recur after using medications or shock wave therapy.

Surgery to remove the gallbladder (cholecystectomy) may be recommended. Gallstones do not come back if the gallbladder is removed. Some people may have more frequent bowel movements following gallbladder removal surgery.

If stones are small enough, they may exit the gallbladder and pass through the bile ducts, into the intestine, where they are then excreted in your stool.

When gallstones become stuck in the gallbladder or bile ducts they can cause pain, obstructions, and infections.

If gallstones are not treated, they can get bigger and may lead to complications such as:

• Acute cholecystitis – when a stone blocks a bile duct, this can lead to a build-up of bile in the gallbladder, which can result in infection and inflammation
• Pancreatitis – A gallstone blocks the opening of the pancreas, causing inflammation
• Acute cholangitis – When bile ducts become blocked, they can become infected
• Jaundice (yellowing skin and eyes) – if a stone passes out of the gallbladder and into a bile duct, it can block the flow of bile

To help prevent gallstones, eat a high fibre diet including:

• Fruits and vegetables
• Beans
• Whole grains
• Healthy fats (such as fish oil and olive oil)

Avoid foods such as:

• Refined carbohydrates
• Sugary foods
• Fried foods

Risk factors for developing gallstones include:

• Age over 40
• Family history
• Being female
• Pregnancy
• Taking oestrogen
• Obesity
• High fat or high cholesterol diet
• Rapid weight loss (including patients who have had weight loss surgeries)
• Diabetes
• Fasting often
• Sedentary lifestyle
• Sickle cell disease
• Cirrhosis of the liver
• Certain medicines