For patients suspected of having gallstones, is abdominal pain more frequently associated with an acutal diagnosis of gallstones?

Berger MY, et al. Is biliary pain exclusively related to gallbladder stones? A controlled prospective study. Br J Gen Pract. 2004 Aug;54(505):574-9.

To evaluate the relationship between biliary pain, other gastrointestinal symptoms and gallstones.

Neither biliary nor abdominal pain allow for discrimination between patients with and without gallbladder stones.

Prospective study

Patient population: 233 consecutive patients with abdominal pain aged 18 years and older who consulted any of 75 participating general practitioners Jan. 1996-Jun. 1998, and in whom the GP suspected symptomatic gallbladder stones

1.  Questionnaire (at enrollment & 1 year later) on symptoms over previous month:  biliary pain (defined as: acute, steady, severe or very severe, and upper abdominal pain lasting 1 hour or more), upper abdominal pain, upper abdominal pain after fatty food intake, vomiting, nausea, feeling of distension (bloating), belching, acid regurgitation, constipation, diarrhoea, and flatulence.
2.  Ultrasound to diagnose gallstones – radiologist blinded to questionnaire results

Follow-up: 91%


Table 4 shows frequency at time of inclusion of...
Biliary pain:
45% of patients without gallstones
46% of patients w/gallstones who were NOT operated on
65% of patients w/gallstones who were operated on

Upper abdominal pain:
77% of patients without gallstones
73% of patients w/gallstones who were NOT operated on
91% of patients w/gallstones who were operated on

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Clinical Informationist at EUH Branch Library
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