Only about a quarter of all patients with cholelithiasis (gallstones) develop symptoms! Patients with gallstones can live symptom-free for years (silent gallstones). If the stone is located in the ductus cysticus (gallbladder duct) or ductus choledochus (common bile duct), the risk of developing symptoms is increased. More common, however, are stones in the gallbladder, which are less complicated and less likely to cause symptoms.
Symptomatic gallbladder stones present with episodic attacks of pain.
The following symptoms and complaints indicate cholelithiasis (gallstones):
Leading symptom
- Biliary colic – pressing and recurrent crampy attacks of pain lasting more than 15 minutes, localized in the epigastrium, right upper abdomen, and may radiate along the right costal arch into the right scapula; often accompanied by nausea (nausea)/vomiting, possibly also
- Mild rise in temperature to about 38.5 °C rectally;
- Intermittent congestive icterus (congestive jaundice) with dark urine and acholic stools/stools with a white to grayish-white coloration (possibly passive symptoms of pancreatitis/pancreatitis).
Note: Pain duration of > 5 h is predictive of the development of complications.
Associated symptoms
- Dyspeptic symptoms (gallstone dyspepsia), i.e., meteorism (flatulence), bloating, heartburn, feeling of pressure in the upper abdomen, and anorexia (loss of appetite); symptoms occurring at or after meals, especially after high-fat meals
- Possibly nausea (nausea)/vomiting.
- Possibly stool irregularities
- Food intolerances (food intolerances).