Gallbladder stones (cholelithiasis) can remain silent for years, but when they obstruct the cystic duct or migrate into the bile duct they produce a characteristic symptom cluster:

1. Biliary colic
   Sudden, steady pain in the right upper quadrant or epigastrium builds over 15–30 minutes, lasts 30 min – several hours, and may radiate to the right shoulder or back; it is not relieved by positional change, bowel movement, or antacids .
2. Post-prandial trigger
   Pain typically follows a fatty or large meal as gall-bladder contraction forces a stone against the duct opening .
3. Nausea and vomiting
   Gastric stasis and vagal stimulation produce pronounced nausea with occasional bilious vomiting that accompanies rather than precedes the pain .
4. Epigastric bloating and belching
   Patients describe a tight, gassy sensation and frequent sour eructation that mimics dyspepsia.
5. Intolerance to fatty foods
   Fear of post-meal pain leads to voluntary fat avoidance and sometimes weight loss.
6. Complication signs
   Persistent pain >6 h, high fever, jaundice, dark urine and pale stools suggest stone migration into the common bile duct with possible cholangitis or pancreatitis and require urgent care .

Any recurrent upper-abdominal pain related to meals should prompt abdominal ultrasound and liver-function tests to confirm the diagnosis and plan early cholecystectomy.

Symptom	Typical Pattern	Alarm for Complication
Pain	RUQ/epigastric, 30 min–hours, radiates to shoulder	>6 h, constant, severe
Nausea/vomiting	Follows onset of pain	Persistent with fever
Food trigger	Fatty meal, large dinner	—
Bowel	Bloating, belching	Pale stool, dark urine
Fever	Absent in simple colic	Present with jaundice
Systemic	Well between attacks	Rigors, hypotension