Stone disease (lithiasis) encompasses the formation of insoluble concretions within hollow viscera or excretory ducts. The commonest sites are the biliary tree, urinary tract, and salivary glands. Symptoms arise when calculi obstruct luminal flow, provoke spasm, or incite inflammation. Although each organ displays site-specific features, a shared pathophysiological sequence allows recognition of a common clinical pattern.

1. Colicky pain
   Sudden, severe, spasmodic pain that builds rapidly, plateaus for minutes to hours, then wanes. It is mediated by smooth-muscle spasm and elevated intraluminal pressure. Location reflects the affected conduit: right upper quadrant (biliary), flank or lower abdomen (urological), or buccal swelling during meals (salivary).
2. Autonomic accompaniments
   Nausea, vomiting, diaphoresis, and restlessness are triggered by visceral afferent stimulation and are characteristic of severe colic regardless of site.
3. Obstructive sequelae
   Complete blockage leads to upstream distension and stasis. In the biliary tract this produces jaundice, pale stools, and dark urine; in the urinary tract it causes oliguria, hydronephrosis, and rising serum creatinine; in salivary ducts it results in meal-related glandular swelling that subsides slowly.
4. Superimposed infection
   Fever, rigors, and localized tenderness herald bacterial invasion of stagnant fluid—acute cholangitis, acute pyelonephritis, or suppurative sialadenitis.
5. Haemorrhage or abrasion
   Sharp calculi may erode mucosa, giving rise to haematuria, haemobilia, or blood-tinged saliva.
6. Intermittent nature
   Symptoms characteristically remit when the stone disimpacts or passes, only to recur when another calculus lodges.