Symptoms

About 90% of gallstones provoke no symptoms at all. If they do occur, the chance of developing pain is about 2% per year for the first ten years after stone formation, after which the chance for developing symptoms declines. On average, symptoms take about eight years to develop. The reason for the decline in incidence after 10 years is not known, although some doctors suggest that "younger," smaller stones may be more likely to cause symptoms than larger ones.

Biliary Pain

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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. A typical attack has several features:

• The primary symptom is typically a steady gripping or gnawing pain in the upper right abdomen near the rib cage, which can be quite 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.
• Changes in position, over-the-counter pain relievers, and passage of gas do not relieve the symptoms.
• Biliary colic typically disappears after one to several hours. If it persists beyond this point then 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 precipitate the pain, but it usually occurs several hours after eating and often wakes the patient during the night.
• Recurrence is common but attacks can be years apart. In one study, for example, 30% of people who had had one or two attacks experienced no further biliary pain over the next ten years.