Correlation between gallstones and abdominal symptoms in a random population. Results from a screening study

A population sample of 2464 persons between 20 and 70 years of age was included in a screening study designed for establishing gallstone prevalence rates and the frequency distribution of abdominal symptoms in groups with and without gallstone(s). The response rate was 55.6%. Two hundred and eighty-five persons had unoperated gallstone disease, as diagnosed by ultrasound. They were compared with 1044 individuals without ultrasonographically detected gallstones. The frequency distribution of epigastric and/or substernal burning, upper or lower abdominal pain, intolerance to fatty food, nausea and/or vomiting, and jaundice was similar for the two groups. Of the screened population 35% have had to see a physician for abdominal symptoms, with no difference between the two groups. In conclusion, abdominal symptoms are common in individuals with and without gallstone(s), but no differences were found in frequency distribution of symptoms between the groups. Consequently, gallstone disease is asymptomatic in the vast majority of individuals. The high proportion of abdominal symptoms in the population with gallstone(s) combined with increasing ultrasonographic activities may lead to unjustifiable cholecystectomies.