[2][3] However, when a gallstone obstructs the bile duct and causes acute cholestasis, a reflexive smooth muscle spasm often occurs, resulting in an intense cramp-like visceral pain in the right upper part of the abdomen known as a biliary colic (or "gallbladder attack").

[4][6] Symptoms of these complications may include pain that lasts longer than five hours, fever, yellowish skin, vomiting, dark urine, and pale stools.

[5] The presence of stones in the gallbladder is referred to as cholelithiasis, from the Greek chole- (χολή, 'bile') + lith- (λίθος, 'stone') + -iasis (ἴασις, 'process').

[1] The presence of gallstones in the common bile duct is called choledocholithiasis, from the Greek choledocho- (χοληδόχος, 'bile-containing', from chol- + docho-, 'duct') + lith- + -iasis.

Gallstones within the ampulla of Vater can obstruct the exocrine system of the pancreas and can result in pancreatitis.

[15] A characteristic symptom of a gallstone attack is the presence of colic-like pain in the upper-right side of the abdomen, often accompanied by nausea and vomiting.

If one or more gallstones block the bile ducts and cause bilirubin to leak into the bloodstream and surrounding tissue, jaundice and itching may also occur.

[18] Other complications can include ascending cholangitis, which occurs when a bacterial infection causes purulent inflammation in the biliary tree and liver, and acute pancreatitis caused by blockage of the bile ducts that prevents active enzymes from being secreted into the bowel, instead damaging the pancreas.

Risk factors for pigment stones include hemolytic anemias (such as from sickle-cell disease and hereditary spherocytosis), cirrhosis, and biliary tract infections.

[31][32] Additionally, prolonged use of proton pump inhibitors has been shown to decrease gallbladder function, potentially leading to gallstone formation.

This can be caused by high resistance to the flow of bile out of the gallbladder due to the complicated internal geometry of the cystic duct.

[36] The second factor is the presence of proteins in the liver and bile that either promote or inhibit cholesterol crystallization into gallstones.

[3] Gallstones can vary in size and shape from as small as a grain of sand to as large as a golf ball.

Pseudoliths, sometimes referred to as sludge, are thick secretions that may be present within the gallbladder, either alone or in conjunction with fully formed gallstones.

In floating gallstones, reverberation echoes (or comet-tail artifact) is seen instead in a clinical condition called adenomyomatosis.

[40] A positive Murphy's sign is a common finding on physical examination during a gallbladder attack.

[42][43] Side effects of extracorporeal shock wave lithotripsy include biliary pancreatitis and liver haematoma.

[44] The term is derived from the Greek words meaning 'breaking (or pulverizing) stones': litho- + τρίψω, tripso).

[54] Surgery carries risks and some people continue to experience symptoms (including pain) afterwards, for reasons that remain unclear.

[58][59] A 2013 meta-analysis concluded that UDCA or higher dietary fat content appeared to prevent formation of gallstones during weight loss.

CDCA treatment can cause diarrhea, mild reversible hepatic injury, and a small increase in the plasma cholesterol level.

The most highly prized gallstones tend to be sourced from old dairy cows, termed calculus bovis or niu-huang (yellow thing of cattle) in Chinese.