How do I know if it's a proper gallbladder attack, and when do I actually need to go to A&E rather than just riding it out at home?

I've had gallstones confirmed on a scan and I'm on the waiting list, but in the meantime I keep getting these episodes and I genuinely cannot tell what counts as normal for gallstones and what counts as "put your shoes on and go to hospital". Last night was the worst yet. A hard band of pain up under my right ribs that came on maybe an hour after a fairly rich dinner, and it just SAT there and gripped for about two hours before easing off on its own. I was sweating and couldn't get comfortable in any position.

Here's my problem. If that's just what a gallstone attack is, fine, I'll ride them out until my operation. But every time one hits I lie there wondering if this is the one that's actually dangerous and I'm being an idiot for not going in. So what's the difference between a normal attack that passes and the kind where you're supposed to go to A&E. Is it about how long it lasts? Is it a temperature? I don't want to clog up an emergency department over indigestion but I also don't want to be the woman who sat at home while her gallbladder went septic. Also does it HAVE to be after fatty food because a couple of mine weren't.

That two hour gripping thing under the right ribs is the classic attack, that's exactly what mine were before they took it out. Comes, peaks, fades. Horrible but it passes. Mine were usually after a big or greasy meal but not always, sometimes they just turned up in the evening for no reason I could pin down. So no it doesn't have to be a fry up that sets it off.

The thing I held onto was that a plain attack, however grim, eases off after a couple of hours and leaves you shaken but basically ok. What I was told to watch for was the one that DOESN'T ease, especially with a fever or shivering, or if I went yellow. That's the line between "attack" and "something's blocked or infected now". Yours easing off after two hours sounds like the run of the mill kind, but you know your own body.

Denise, the short answer first so you have a rule you can use at 2am, then the detail. A typical gallstone attack, called biliary colic, is a severe gripping pain high in the right upper abdomen that builds, plateaus, and then settles by itself, usually within minutes to a few hours. It often follows a fatty meal but genuinely does not have to, so do not use "it wasn't after food" to talk yourself out of what it is. That, on its own, unpleasant as it is, is the pain you are on the list to have fixed, and riding it out is reasonable while you wait. What the site's guide to gallbladder attack symptoms describes is exactly what you had last night.

Now the part that matters more, the red flags that change it from "wait" to "be seen". Go and be assessed the same day, and A&E if it is out of hours, if the pain does not settle after several hours and just keeps going, if you develop a fever or shaking chills alongside it, if the whites of your eyes or your skin turn yellow, if your urine goes dark or your stools go pale, or if you are vomiting and cannot keep fluids down. Those point to an inflamed, infected gallbladder or a stone that has blocked the main bile duct, which are the events that turn a manageable problem urgent. The reason we treat symptomatic stones rather than watching them is that people in your position carry roughly a 1 to 4 percent per year risk of exactly one of those complications, so your instinct not to simply ignore them is sound. There is more on the infected, hot gallbladder in the piece on acute cholecystitis.

One honest caveat. I can give you the general rule but I cannot tell you which category any single episode of yours falls into, because that needs someone examining you, checking your temperature, and sometimes a blood test or scan on the day. If an episode ever has one of those red flags with it, that is a call to your own GP or the emergency team, not a forum post.

That yellow warning is the one that made me actually take mine seriously. Bookmark the reply above honestly.

Reporting back so this is useful for the next worried person. I've had two more of the standard two hour ones since, rode them out with a hot water bottle and they passed, no fever, no yellow, so I stayed put and just noted them down. Having a clear list of what would actually send me in has stopped me second guessing every twinge, which was honestly half the misery of waiting. Op date came through for February. Counting down.