Many individuals have gallstones present in their gallbladders. The majority never cause problems. However, in certain individuals they may cause symptoms.

Symptoms

• Biliary colic - This is the most common symptom caused by gallstones. This occurs when a stone moves to sit in the neck of the gallbladder. When the gallbladder contracts, e.g. after eating, this can cause pain in the right upper quadrant or epigastric region (See Abdominal pain) that may be burning or cramping in nature. In this situation it is usually advised that the gallbladder be surgically removed.
• Right upper quadrant pain - Pain in the right upper part of the abdomen is usually caused by diseases of the liver or biliary tract. RUQ pain can be a manifestation of inflammation of the gallbladder, biliary colic or even infection of the bile ducts (See below).
• Jaundice - Gallstones usually do not cause jaundice unless they have moved out of the gallbladder into the common bile duct, leading from the liver to the small bowel. Once in the common bile duct they can cause blockage, and even infection (See below). 

Complications

• Inflammation of the gallbladder can occur as a result of various diseases. The most common cause is a gallstone blocking the neck of the gallbladder. Inflammation can be acute, with individuals becoming feverish and experiencing severe abdominal pain. It can also be chronic, with longstanding pain in the right upper part of the abdomen.
• Obstructive jaundice - Gallstones may also move into the common bile duct, which drains into the small bowel. Here they can cause a blockage which results in right upper quadrant pain, jaundice and possibly infection of the bile ducts – called cholangitis.
• Cholangitis - Infection of the bile ducts ("cholangitis") can be life-threatening and it is very important to relieve the blockage causing the infection quickly. The best way to achieve this is usually by a procedure called an ERCP (See Endoscopic Retrograde Cholangiopancreaticography).
• Pancreatitis - Gallstones moving down the common bile duct can also cause pancreatitis (inflammation of the pancreas). This condition may be severe and life-threatening.

If any of these complications develop from gallstones, then it is recommended to remove the gallbladder surgically (cholecystectomy). This is usually performed laparoscopically (“key-hole surgery”), but if it is a difficult operation then a traditional surgical procedure may be done. Sometimes gallstones are found in the common bile duct after cholecystectomy, and need to be removed by ERCP.