Abdominal pain
One of the most critical symptoms of gallstones is abdominal pain. Severe and acute abdominal pain is a warning sign that gallstones might be obstructing the normal flow of bile through the bile duct, and mild pain or discomfort is the result of a partial blockade, which is common when they are still in the gallbladder. This is probably the most important sign because it is what drives patients to visit the doctor, and during a physical exam this type of pain, its location, intensity, and other signs would lead us to strongly suspect a final diagnosis.
An obstruction in the bile duct causes severe abdominal pain. It is a type of colic pain because the bile duct is continuously undergoing jerking movements trying to clear out the problem. This type of pain is commonly located in the upper right area of the abdomen, near the ribcage, but might also be located in the middle area of the abdomen depending on the anatomical disposition of the gallbladder. Pain should be assessed along with other signs and symptoms. Otherwise, it has not much diagnostic value.
On the other hand, mild pain or abdominal discomfort is common in patients with undiagnosed or untreated gallstones. This type of pain is more common after a fatty or large meal, and it is located in the same area. There are clues that would lead us to suspect gallstones. First off, it is a type of pain that often comes after a large meal, and second, it is not the same colic pain you experience in stomach cramps and may include nausea and vomiting as well.