The majority of patients with gallstones are asymptomatic and will remain so throughout their lives. Of those with incidental (asymptomatic) gallstones, approximately 15 to 25 percent will become symptomatic after 10 to 15 years of follow-up.
Patients with symptomatic uncomplicated gallstone disease typically present with biliary colic, a normal physical examination, and normal laboratory test results. Biliary colic is an intense, constant, dull discomfort usually located in the right upper quadrant or epigastrium that may radiate to the back (particularly the right shoulder blade). The pain is often associated with diaphoresis, nausea, and vomiting.
Symptoms other than biliary colic have been reported in patients with gallstones, but their predictive value for the presence of gallstone disease is poor. Atypical symptoms include belching, fullness after meals/early satiety, regurgitation, abdominal distension/bloating, epigastric or retrosternal burning, nausea or vomiting, chest pain, and nonspecific abdominal pain.
Complications include acute cholecystitis, choledocholithiasis with obstruction (with or without acute cholangitis), and gallstone pancreatitis. Rare complications include gallstone ileus, Mirizzi syndrome, and gallbladder cancer.