Abdominal symptoms and gallstone disease: an epidemiological investigation

To date, it has never been established which symptoms are specifically caused by stones in the gallbladder. To examine this issue, the relationship between occurrence of gallstone disease diagnosed by ultrasonography and complaints about abdominal pain and discomfort was assessed in a random sample comprising 4,581 males and females, of whom 3,608 (79%) took part in the investigation. As regards the presence of gallstones, the predictive values of various complaints about pain and discomfort were very low, ranging from zero to 25.0%, whereas for the absence of gallstones the predictive value of no complaints about pain or discomfort was very high, ranging from 93.2 to 94.2%. In subjects with gallstones, the prevalence of upper right quadrantic pain during the last 12 months was equal to that in subjects with a normal gallbladder, whereas in cholecystectomized subjects the prevalence of pain was significantly higher. Pain was not associated with size, number or motility of the stones. It is concluded that in a random population it is difficult to define the symptoms specific for gallstones and thereby to distinguish between symptomatic and asymptomatic gallstones.