Ultrasound is the test of choice for gallstones and it is very good at it. What it does not see is the stomach or the bowel — so if your symptoms are reflux, bloating, altered bowel habit or abdominal cramping, an ultrasound may not be the test that answers them. Knowing which half of the digestive system your symptoms point to is what decides whether this is the right scan.
Contents
See your GP urgently — not a scan — if you have: difficulty swallowing; unintended weight loss; blood in your stool or black tarry stools; persistent vomiting; a lump in your abdomen; yellowing of the skin or eyes; or new digestive symptoms over the age of 50. These warrant referral on an urgent suspected-cancer pathway, which aims for specialist assessment within two weeks.
Sound travels well through solid organs and fluid, and not at all through gas. That single fact divides the digestive system in two as far as ultrasound is concerned.
| Seen well | Not seen |
|---|---|
| Gallbladder and bile ducts | Oesophagus |
| Liver | Stomach lining |
| Pancreas (head and body) | Small bowel |
| Spleen | Colon |
| Kidneys | Rectum |
| Free fluid in the abdomen | Pancreatic tail (often) |
The practical translation: ultrasound is an organ test, not a gut test. Reflux, ulcers, coeliac disease, inflammatory bowel disease, IBS and bowel cancer are all diagnosed by endoscopy, colonoscopy, blood tests or stool tests — not by a scan.
Gallstones are where abdominal ultrasound genuinely excels. It is the first-line test, detects the great majority of stones, and does so in a fifteen-minute appointment with no radiation.
The pattern worth recognising in yourself:
That is biliary colic, and it is routinely mistaken for indigestion for months or years — partly because it responds temporarily to antacids and partly because it comes and goes.
The distinction from true indigestion: reflux tends to be central, burning, worse lying flat, and relieved by antacids. Gallbladder pain tends to be right-sided, gripping, unrelated to posture, and unrelieved by antacids.
Gallstone pain that does not settle within a few hours, or comes with fever, shivering or jaundice, needs same-day assessment. That combination suggests infection of the gallbladder or an obstructed bile duct, which are treated in hospital rather than in an outpatient clinic.
Worth stating plainly, because booking the wrong test costs you time as well as money:
If your symptoms are lower abdominal, related to bowel habit, or have changed recently, start with your GP rather than with a scan.
Right upper quadrant pain is one of the most common presenting symptoms in our abdominal ultrasound service. In a significant proportion of cases, the scan identifies gallstones the patient was not aware of.
In most of these cases, the patient has been experiencing intermittent symptoms for months or years and has attributed them to indigestion or a dietary intolerance. The scan provides a clear diagnosis, which they can then take to their GP to discuss management options.
The ability to access this investigation within days, without a referral, at a transparent price, is one of the most practical benefits of private abdominal ultrasound.
Drawn from typical cases seen at our Marylebone clinic. A composite scenario representative of patterns we encounter regularly, not any individual case.
Yes — it is the first-line test and detects the great majority of gallstones. You need to fast for six hours beforehand so the gallbladder is full, because a contracted gallbladder cannot be assessed properly.
No. Gas in the stomach and bowel blocks the sound waves. Reflux, ulcers, coeliac disease, inflammatory bowel disease and bowel cancer are diagnosed by endoscopy, colonoscopy or blood and stool tests.
Gallstone pain is typically upper right, gripping, comes on after fatty food, lasts 30 minutes to a few hours, and is not relieved by antacids. Reflux is usually central, burning, worse lying flat, and does respond to antacids. If in doubt, get it looked at.
No. Abdominal ultrasound does not assess the bowel lining and cannot screen for or exclude bowel cancer. If you have blood in your stool, a change in bowel habit lasting more than three weeks, or unexplained weight loss, see your GP urgently.
Yes — six hours, water only. Eating empties the gallbladder and produces gas that obscures the pancreas and bile ducts.
Sometimes. It will not explain most bloating, but in women it is used to exclude ovarian and pelvic causes, which is an important thing to rule out. Persistent bloating — more than twelve times a month — should be discussed with your GP.
An upper abdominal ultrasound is £235. You receive instant verbal results at the appointment, with the written report following within 24 hours.
Related: abdominal pain and when to get a scan, what your abdominal report means, and the upper abdominal ultrasound service page.
CQC-registered clinic · HCPC-registered sonographers · BMUS member · ICO-registered. Reports can be shared securely with your NHS GP or specialist at your request.
