Gallstone disease history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

Overview

Gallstone disease can manifest in a number of ways. Most patients have a history of obesity, multiple pregnancies, use of oral contraceptive pills, age of 40 years old and over, female and of Caucasian or Native American race. Some patients may be in a physical state that favors the development of gallstones but don't develop them, some patients may have gallstones, but are asymptomatic. These gallstones are detected incidentally. Some may have gallstones and experience biliary colic, nausea, vomiting and diarrhea, whilst others will have complications due to gallstones, such as acute cholecystitis and acute pancreatitis.

History and Symptoms

History

• Obtaining history is an important aspect of making a diagnosis of gallstone disease.

• The areas of focus should be on onset, duration, and progression of symptoms such as:
  • Obesity
  • Eating fatty foods
  • Multiparity
  • Age over 40
  • Female
  • Oral contraceptive pill
  • Caucasian or Native American race

Common Symptoms

• The majority of patients with gallstone disease are asymptomatic.
• Patients start developing symptoms once the stones reach a certain size (>8mm):
  • Right upper quadrant pain or biliary colic: intense pain in the upper abdominal region
    • The pain steadily increases for approximately thirty minutes to several hours.
    • Pain is sometimes referred to the middle of the back or the tip of the right shoulder.
  • Nausea
  • Vomiting
  • Diarrhea

Less Common Symptoms

Less common symptoms include:

• Chest pain
• Fullness after eating or early satiety
• Frequent belching