What are the symptoms of cholelithiasis (gallstones)?

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Last updated: April 10, 2025View editorial policy

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From the Guidelines

Cholelithiasis, or gallstones, often presents with specific symptoms that can help identify this condition, including right upper quadrant abdominal pain, nausea, vomiting, and intolerance to fatty foods, as noted in studies such as 1 and 1. The most common symptom is right upper quadrant abdominal pain, which typically occurs after eating fatty meals and may radiate to the right shoulder or back. This pain, known as biliary colic, usually lasts from 30 minutes to several hours. Other symptoms include:

  • Nausea
  • Vomiting
  • Bloating
  • Indigestion
  • Intolerance to fatty foods Some patients may experience fever and chills if the gallstone causes an infection (cholecystitis), as mentioned in 1. Jaundice, characterized by yellowing of the skin and eyes, can occur if a stone blocks the bile duct. Dark urine and light-colored stools may also be present in cases of bile duct obstruction. It's essential to note that many people with gallstones remain asymptomatic, with stones discovered incidentally during imaging for other conditions, as stated in 1. The pain occurs because gallstones block the flow of bile, causing the gallbladder to contract against the obstruction, which stimulates pain receptors. If symptoms are severe or persistent, medical attention should be sought as complications like inflammation, infection, or pancreatitis can develop, highlighting the importance of proper diagnosis and treatment, as discussed in 1 and 1.

From the Research

Symptoms of Cholelithiasis

The symptoms of cholelithiasis can vary, but common presentations include:

  • Right upper quadrant pain of the abdomen that is often elicited upon palpation during physical examination and documented as a positive Murphy's sign 2
  • Referred pain to the right supraclavicular region and/or shoulder 2
  • Nausea 2
  • Vomiting 2 It is worth noting that lack of physical examination findings does not rule out a diagnosis of cholelithiasis 2.

Complications of Cholelithiasis

Cholelithiasis can result in complications, including:

  • Cholecystitis (inflammation of the gallbladder) 2
  • Cholangitis (inflammation of the bile duct) 2

Diagnosis of Cholelithiasis

Laboratory tests such as white blood cell count, liver enzymes, amylase, and lipase may assist the clinician in diagnosing cholelithiasis, however, ultrasonography is the gold standard for diagnosis 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Cholelithiasis: Presentation and Management.

Journal of midwifery & women's health, 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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