From the Guidelines
If you have gallstones, you should see a gastroenterologist, a physician who specializes in digestive system disorders. These specialists are trained to diagnose and treat conditions affecting the gallbladder, including gallstones. In some cases, your primary care physician might refer you directly to a general surgeon, particularly if your gallstones are causing significant symptoms and surgical removal of the gallbladder (cholecystectomy) is likely needed. During your appointment, the specialist will typically review your symptoms, medical history, and may order imaging tests such as an ultrasound, CT scan, or MRCP (magnetic resonance cholangiopancreatography) to confirm the diagnosis and assess the severity of your condition. Treatment options depend on your symptoms - asymptomatic gallstones often require no treatment, while painful or complicated cases may require surgery, as suggested by the guidelines for the treatment of gallstones 1. However, the most recent guideline on the management of common bile duct stones (CBDS) published in 2017 1 provides updated guidance to healthcare professionals who are involved in the care of adult patients with suspected or proven CBDS, which may be relevant to the management of gallstones. Gallstones form when substances in bile (particularly cholesterol or bilirubin) harden into stone-like deposits, and proper specialist care is essential to prevent complications like inflammation, infection, or blockage of bile ducts. Key considerations in the management of gallstones include:
- The presence of symptoms, such as biliary pain
- The size and location of the stones
- The patient's overall health and medical history
- The potential risks and benefits of different treatment options, including surgery, endoscopic retrograde cholangiopancreatography, and radiological methods of stone extraction. By seeing a gastroenterologist or general surgeon, you can receive a proper diagnosis and treatment plan tailored to your individual needs, as recommended by the guidelines 1.
From the Research
Specialist for Gallstones
To determine the specialist someone should see if they have gallstones, we need to consider the treatment options available for gallstones.
- According to the study 2, laparoscopic cholecystectomy is the standard treatment for symptomatic gallstones, acute cholecystitis, and gallstone pancreatitis.
- This suggests that a general surgeon or a gastrointestinal surgeon would be the appropriate specialist to see for gallstones, as they would be able to perform the necessary surgery.
Alternative Treatment Options
However, there are also alternative treatment options available for gallstones, such as ursodeoxycholic acid (UDCA) therapy.
- The study 3 discusses the use of UDCA for symptomatic gallstones, and suggests that it may be a viable treatment option for patients who are unfit for surgery.
- The study 4 also supports the use of UDCA for preventing gallstone disease after laparoscopic sleeve gastrectomy.
- The study 5 found that UDCA treatment was effective in improving symptoms in patients with postcholecystectomy pain and bile microlithiasis.
- The study 6 provides a review of the use of UDCA in gallbladder disease, and highlights its potential as a non-invasive, non-surgical treatment option.
- This suggests that a gastroenterologist may also be a suitable specialist to see for gallstones, as they would be able to prescribe and manage UDCA therapy.