Is biliary pain exclusively related to gallbladder stones?
Berger MY; Olde Hartman TC; van der Velden JJ; Bohnen AM Department of General Practice, Erasmus MedicalCentre, Rotterdam, The Netherlands. m.berger@erasmusmc.nl BACKGROUND: The uncertainty around true clinical manifestations of gallbladder stone disease is in contrast with the unanimous recommendation that only symptomatic gallstones should be treated. AIM: To evaluate the relationship between biliary pain, other gastrointestinal symptoms and gallstones. DESIGN OF STUDY: A pragmatic, prospective cohort questionnaire study. SETTING: Seventy-five general practices in Rotterdam, The Netherlands. METHOD: All patients suspected by their general practitioner (GP) to have gallstone disease underwent ultrasound examination of the upper abdomen. Using a self-administered questionnaire, the presence of 11 gastrointestinal symptoms was assessed at inclusion and after 1 year. Likelihood ratios (LRs) for the presence of gallstones and symptom relief rates after 1 year were calculated. The mean dif