Gallstones and Gallbladder Disease - Symptoms

Symptoms

About 90% of gallstones cause no symptoms. There is a very small (2%) chance of developing pain during the first 10 years after gallstones form. After 10 years, the chance for developing symptoms declines. On average, symptoms take about 8 years to develop. The reason for the decline in symptoms after 10 years is not known, although some doctors suggest that "younger," smaller stones may be more likely to cause symptoms than larger, older ones. Acalculous gallbladder disease will often cause symptoms similar to those of gallbladder stones.

Biliary Pain or Colic

The mildest and most common symptom of gallbladder disease is intermittent pain called biliary colic, which occurs either in the mid- or the right portion of the upper abdomen. Symptoms may be fairly nonspecific. A typical attack has several features:

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• The primary symptom is typically a steady gripping or gnawing pain in the upper right abdomen near the rib cage, which can be severe and can radiate to the upper back. Some patients with biliary colic experience the pain behind the breast bone.
• Nausea or vomiting may occur.
• Changing position, taking over-the-counter pain relievers, and passing gas do not relieve the symptoms.
• Biliary colic typically disappears after 1 to several hours. If it persists beyond this point, acute cholecystitis or more serious conditions may be present.
• The episodes typically occur at the same time of day, but less frequently than once a week. Large or fatty meals can trigger the pain, but it usually occurs several hours after eating and often awakens the patient during the night.
• The condition commonly returns, but attacks can be years apart.

Digestive complaints such as belching, feeling unusually full after meals, bloating, heartburn (burning feeling behind the breast bone), or regurgitation (acid back-up in the food pipe) are not likely to be caused by gallbladder disease. Conditions that may cause these symptoms include peptic ulcer, gastroesophageal reflux disease, or indigestion of unknown cause. [For more information, see In-Depth Report #19 Peptic ulcers and In-Depth Report #85 Gastroesophageal reflux disease.]