Ultrasound is the best first test for gallstones. Learn what it shows, how to prepare, what the report terms mean and when surgery is advised.
Gallbladder ultrasound is the best first test for gallstones. It shows stones, thickened walls, sludge, polyps and dilated bile ducts, without radiation, and is more than 90 percent accurate for stones in the gallbladder. Fasting for 6 to 8 hours makes the gallbladder full and the images clearer.
Symptoms of Gallstone Disease
- Pain in the right upper belly or centre, often after fatty food, lasting 30 minutes to hours
- Pain spreading to the back or right shoulder blade
- Nausea, vomiting, bloating
- Fever, yellow eyes and dark urine suggest complications
Many people with stones have no symptoms. See ultrasound abdomen.
How to Prepare
Fast for 6 to 8 hours. Water is allowed in small sips. Avoid fatty meals the night before. The scan takes 10 to 20 minutes, and the sonologist may ask you to turn on your side to see stones move. Bring old reports.
Report termMeaningCholelithiasis / calculusGallstonesSludgeThick bile; may form stonesWall thickeningInflammation (cholecystitis) or other causesPolypSmall growth; size decides follow-upCBD dilatedBile duct widened; possible stone or blockageWhen Is Surgery Advised?
- Gallstones with repeated pain attacks
- Acute cholecystitis (infection of the gallbladder)
- Stones in the bile duct or pancreatitis from stones
- Gallbladder polyps larger than 1 cm, or growing quickly, or in people with risk factors
- Gallstones with a calcified (porcelain) gallbladder wall
Keyhole gallbladder removal is a common safe operation, and most people go home in a day or two.
Silent Gallstones and Polyps
Silent stones usually need no surgery and can be watched. Small polyps under 6 mm are mostly cholesterol deposits; repeat ultrasound is advised at intervals. In north India, with a higher rate of gallbladder cancer, doctors may be more cautious about large stones and polyps. See PET CT for gallbladder cancer.
Other Tests When Ultrasound Is Not Enough
CT shows complications and tumours, MRCP shows small bile duct stones, and endoscopic ultrasound finds tiny stones and sludge. See CT scan for gallbladder and bile duct problems.
A Practical Example
Poonam, 38, has pain after meals. Ultrasound shows several small stones and a normal bile duct. Her surgeon advises keyhole removal, and she is pain-free afterwards. Her husband, with silent stones found by chance, chooses regular review since he has no symptoms.
Key Facts at a Glance
- Ultrasound is the first test for gallstones
- Fasting for 6 to 8 hours gives a better scan
- Surgery is advised for symptomatic stones
- Fever, jaundice and severe pain need urgent care
After the Scan and Next Steps
Take the report to a surgeon or physician. After gallbladder removal, eat small, low-fat meals at first and increase gradually. Maintain a healthy weight, since rapid weight loss and obesity increase stone risk. Report fever, yellow eyes, dark urine or severe pain without delay.
Questions to Ask Your Doctor
- Are my symptoms caused by gallstones?
- Do I need surgery now or can I watch?
- Is my bile duct normal?
- What diet should I follow?
Common Mistakes to Avoid
- Ignoring repeated pain after fatty meals.
- Eating before the scan.
- Crash dieting, which can form new stones.
Booking, Timing and Report
Ultrasound is usually available without a long wait, and many scans can be done the same day. Carry your doctor's prescription and old ultrasound reports, and follow the instructions about a full or empty bladder or fasting. The scan takes 15 to 30 minutes, and the report is usually ready the same day.
Understanding Your Report
The report will give the number and size of stones, the wall thickness in millimetres, the diameter of the common bile duct and whether there is fluid around the gallbladder. A bile duct larger than about 6 mm (more after gallbladder removal or with age) needs attention, particularly with jaundice or pain. Ask your doctor whether MRCP or blood tests of liver function are needed.
Frequently Asked Questions
How accurate is ultrasound for gallstones?
Very accurate for stones in the gallbladder.
Do I need to fast?
Yes, 6 to 8 hours.
Are all gallstones removed by surgery?
Symptomatic ones usually are.
Can gallstones dissolve with medicines?
Rarely and slowly.
What is sludge?
Thick bile that may form stones.
Are polyps dangerous?
Most small ones are harmless; large ones need review.
Can stones cause pancreatitis?
Yes.
How long does the scan take?
10 to 20 minutes.
When is the report ready?
Usually the same day.
Book Your Test at Ganesh Diagnostic
Ganesh Diagnostic & Imaging Centre in Rohini, Delhi offers this test with trained radiology staff and clear reports. You can book an appointment online, check our branches across Delhi NCR, contact us for current rates, or explore all our services. Reports can be downloaded online through our patient portal, so you do not need to make a second trip just to collect them.
This article is for general information only. It does not replace advice from your doctor. Always follow your doctor's instructions for your test.
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