Gallbladder Physical Exam

Abdominal pain is one of the most common symptoms experienced by patients around the world. It’s not always a sign of serious disease but it can reflect problems in your gallbladder. At our Beverly Hills medical office, specialists perform a full gallbladder physical exam to identify the cause of your abdominal pain and detect any abnormalities in your gallbladder.

What is the gallbladder?

The gallbladder is a small pear-shaped pouch located under your liver. Its function is to store and secrete a special type of digestive juice called bile. Bile is produced in the liver and it plays a role in the process of breaking down fatty foods. The gallbladder is connected to the liver through a bile duct system which transports bile to be stored in the gallbladder.

Types of gallbladder disease

There are several types of gallbladder disease, most of them are caused by inflammation. Their symptoms are most prominent after a fatty meal. It is important to diagnose these conditions early so that serious complications are avoided.

Cholecystitis & Cholangitis

Cholecystitis is inflammation of the gallbladder and cholangitis is inflammation of the bile ducts. Cholecystitis is the most common type of gallbladder disease. It can be triggered by gallstones, tumors, or other conditions. Symptoms include fever, nausea, vomiting, abdominal pain, and jaundice (yellowish discoloration of mucosa and/or skin).


Gallstones, also known as cholelithiasis, develop when chemical substances like calcium or bile salts accumulate and form particles that block the gallbladder or its associated ducts. This blockage causes gallbladder dysfunction. There are five risk factors for developing gallstones, they are called the five F’s: female, fertile, forty, fatty, and fair. Gallstones often result in pain, called biliary colic, in the right upper quadrant of the abdomen, nausea, and vomiting.

Biliary dyskinesia

Biliary dyskinesia is when the bile is not properly squeezed out because the gallbladder is not contracting as it should. Its reduced activity leads to bloating and indigestion. Diagnosing this condition requires special testing such as HIDA scan.

Other gallbladder conditions include:

  • Gallbladder polyps
  • Gallbladder cancer
  • Gallbladder abscess
  • Perforated gallbladder

What to expect

Medical history
Prior to the abdominal physical exam, your physician will ask you some questions. You will need to clarify the following:

  • Detailed account of your symptoms and when they started
  • Factors that trigger or relieve your symptoms
  • Family history of gallbladder or liver disease
  • Medications you’re currently using

Gallbladder physical exam

Physical examination of the gallbladder is typically performed by inspection and palpation. Your physician will check your abdomen for any distension or prominent veins. If your skin is slightly yellowish, this will be noted as well. Afterwards, your doctor will start feeling your abdominal region to check for painful points and masses. A typical sign for cholecystitis is Murphy’s sign which is pain triggered by feeling the right upper quadrant of the abdomen. Whereas cholangitis is characterized by a triad of symptoms called Charcot’s triad: fever, jaundice, and right upper abdominal pain.

Additional testing

To reach a definite diagnosis, after your gallbladder physical exam, your physician may request additional testing. A complete blood count (CBC) will show if your blood levels of white blood cells is elevated. In addition to C-reactive protein (CRP), these two values confirm inflammation. Other blood tests used to diagnose gallbladder dysfunction include bilirubin levels and liver function tests (LFTs) which measure the level of liver enzymes, albumin, and bilirubin. Although not produced by the gallbladder, liver enzymes like ALT, ALP, and GGT can also reflect gallbladder disease. You can provide a blood sample at our medical office to get laboratory blood work done.

Ultrasound testing is an imaging technique used in the diagnosis of gallbladder disease. It is cheap, quick, and noninvasive. Our ultrasound unit is one of the best in Los Angeles so your physician can request one to get a better picture of your gallbladder. Depending on your symptoms, your physician may refer you to another clinic for more advanced imaging tests such as magnetic resonance cholangiopancreatography (MRCP) or endoscopic retrograde cholangiopancreatography (ERCP), which use special equipment to examine and treat gallbladder obstruction.

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