Brief, factual descriptions of conditions that may be discussed during a gastroenterology consultation.
Hong Kong gastroenterology and hepatology information from Dr Paul Ng. Consultations in Central and Tsim Sha Tsui are by appointment; assessment and care are individual.
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Gallbladder
Gallstones
Gallstones are solid particles that form in the gallbladder from components of bile. Many are found incidentally and never cause trouble. If a stone blocks the gallbladder outlet, it may cause a steady pain in the upper abdomen, often after eating; blockage of a bile duct can lead to jaundice, infection or pancreatitis.
Typical gallstone pain often builds in the upper abdomen and lasts for a period before easing; recurring pain may follow meals, but meal timing alone cannot confirm the cause. Ultrasound can show gallbladder stones, while blood tests or additional imaging may be needed if a stone in the bile duct is suspected. Many people with incidentally found stones never develop symptoms and may not need an operation. Persistent pain with fever, yellow skin or eyes, pale stools, dark urine or repeated vomiting can signal a complication and should be assessed urgently. Pain from the gallbladder may be felt in the back or right shoulder, but location can vary and other conditions can mimic it. A clinician will weigh the likelihood that stones explain symptoms against the potential benefit and risk of intervention. A stone seen on a scan may be incidental, so matching the location and timing of pain to the imaging is important before attributing symptoms to it. Sudden severe pain, jaundice or fever can indicate obstruction or infection and should not wait for routine follow-up.
For discussion in consultation
Ultrasound and the pattern of symptoms help distinguish an incidental stone from one causing a problem; blood tests or other imaging may be considered if a duct complication is suspected. The balance between observation and treatment depends on symptoms, complications and overall health. Fever with upper-abdominal pain, jaundice, dark urine or persistent severe pain warrants prompt medical attention.
Related procedure information
ERCP is generally considered for selected bile-duct or pancreatic-duct problems, not uncomplicated gallbladder stones. These links are educational, not a recommendation.
A gallbladder polyp is a small projection seen along the gallbladder wall, most often on ultrasound. Many are cholesterol deposits or other non-cancerous changes rather than true tumours. A smaller number represent growths with potential for malignancy, and an ultrasound label alone cannot reliably tell the tissue type.
Ultrasound may mistake folds, adherent sludge or cholesterol deposits for a polyp, and small measurements can vary between examinations. Reviewing the images and comparing reports helps distinguish a stable finding from a convincing change. Size is important but is not the only consideration: growth pattern, gallbladder-wall appearance and individual risk factors may affect management. Some findings call for no further action, while others merit repeat ultrasound or specialist discussion. Surgery is considered by weighing the estimated risk against the risks and benefits of an operation. The interval for follow-up, if any, is selected according to the finding and patient factors rather than an assumption that every polyp grows. Bring previous imaging reports to review so that apparent growth can be compared consistently. Ask whether the report describes a true fixed wall lesion, its maximum measurement and the scan date; these details are useful when comparing studies. A difference of only a few millimetres may reflect measurement variation rather than definite growth.
For discussion in consultation
Clinicians consider the measured size, shape, whether the wall is thickened, change compared with earlier scans and relevant personal risk factors. Ultrasound measurements have some variability, so a small apparent change may need careful interpretation. Depending on the full picture, follow-up imaging, specialist review or discussion of surgery may be appropriate; decisions are not based on the word “polyp” alone.
Related procedure information
These links are general information, not a recommendation for an examination or treatment.
Persistent or new digestive symptoms after gallbladder removal are sometimes grouped under the term post-cholecystectomy syndrome. The term describes a symptom setting rather than one specific disease: possible causes include retained or recurrent bile-duct stones, bile-duct problems, reflux, functional gut disorders or conditions unrelated to the biliary system. Symptoms may include abdominal pain, indigestion, diarrhoea or jaundice, depending on the cause.
Symptoms after gallbladder removal have a range of possible explanations and the umbrella term does not indicate that the operation caused a single ongoing disorder. Depending on findings, evaluation may include liver tests and non-invasive bile-duct imaging, alongside assessment for common non-biliary causes; procedures such as ERCP are generally reserved for a defined reason because they carry risks.
For discussion in consultation
Review considers the original reason for surgery, timing and character of symptoms, operative records, examination and relevant blood tests or imaging. Tests may evaluate the bile ducts or investigate non-biliary causes; an abnormal symptom pattern alone does not establish a sphincter disorder. The choice of further evaluation depends on the clinical findings because invasive procedures have potential risks.
Related procedure information
These links are general information, not a recommendation for an examination or treatment.
These summaries are for general information only. They cannot establish a diagnosis or determine whether you need tests, surveillance or treatment. Your own results, risks and options must be reviewed in an actual consultation with a qualified clinician. Do not start, stop or change treatment based on this page.
References are provided for background reading; they do not replace a consultation.
Questions about a finding on your scan, blood test or endoscopy report? Discuss the full report and your history in a consultation.
About this information
This is general educational information, not a diagnosis, a personalised recommendation or consent for a procedure. Whether to investigate or treat, the alternatives (including no procedure), benefits and risks require individual clinical assessment and discussion.