Biliary colic is the hallmark gallstone symptom: sudden intense right upper abdominal or epigastric pain starting 30-60 minutes after a fatty meal, lasting 1-5 hours, radiating to the right shoulder blade, with nausea and vomiting. Atypical symptoms: indigestion, bloating, right shoulder pain alone, nausea without pain — easily confused with acid reflux or IBS. Emergency warning signs: fever >38°C + right upper pain (acute cholecystitis), fever + jaundice + abdominal pain (cholangitis — emergency), severe epigastric pain radiating to back (gallstone pancreatitis), yellow skin/eyes + dark urine (bile duct obstruction). Diagnosis: abdominal ultrasound (>95% sensitivity), blood tests (LFTs, FBC, amylase), MRCP for CBD stones. Contact clinic for same-day consultation.

Gallstone Symptoms: How to Recognise a Gallstone Attack