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The hallmark symptom of gallstones is biliary colic , typically presenting as: Sudden-onset pain in the right upper quadrant or epigastrium (upper central abdomen), often described as severe, constant, or cramping Pain radiating to the right shoulder or between the shoulder blades Episodes lasting 30 minutes to several hours , often triggered by fatty meals Associated nausea and vomiting Pain that may wake the patient from sleep When a gallstone obstructs the cystic duct or common bile duct, or when the gallbladder becomes inflamed, more serious complications can develop