28. Biliary colic blog

Biliary colic is a term used to describe the type of pain related to the gallbladder, when the gallbladder contracts and the cystic duct is partially or completely blocked by a gallstone. The symptoms are described below.

Biliary colic is a type of pain that usually occurs in the upper part of your belly (abdomen), usually a little to the right or centrally. In some people, it feels like the pain is radiating to their back or their right shoulder.

The pain usually begins suddenly. Once it begins, it’s usually a moderate, steady pain. Most commonly, an episode of biliary colic happens within a couple of hours after a person has eaten a meal, often a large meal with a lot of fat. Unlike some other kinds of abdominal pain, biliary colic doesn’t improve after having a bowel movement.

Usually the worst of the pain happens about an hour after it starts. Typically, the pain gradually goes away over one to five hours (as the gallstone moves out of the duct). However, the symptoms of biliary colic don’t always follow this pattern. For example, you might have different patterns in the location and pattern of the pain.

Most of the time, people with biliary colic don’t have additional symptoms (though nausea and vomiting do sometimes happen). For example, a person who has a fever is unlikely to be having symptoms from biliary colic.
If the pain persists, or if you have a fever, you might not be experiencing biliary colic but complications from your gallstones. For example, some people with gallstones get cholecystitis (inflammation of the gallbladder), pancreatitis (inflammation of the pancreas), or cholangitis (infection of the biliary tract).

Biliary colic and diet
A diet that is high in calories and refined carbohydrates and low in fiber increases the risk of gallstones.

Refined carbohydrates are foods that have been processed to take the bran out. Examples include white bread or white rice. These foods may increase the risk of gallstones forming.

Food that contains a lot of saturated fat, such as butter, cakes, or fatty meats, including sausages, can raise cholesterol. If cholesterol builds up in the bile, it can lead to gallstones.

A healthful diet contains plenty of fresh fruits and vegetables, whole-grain carbohydrates, and lean proteins. Eating a balanced diet can help to prevent gallstones.

Some people are more at risk of developing gallstones than others and are more likely to experience biliary colic. These groups include:
  • women
  • people over 40 years old
  • people who are obese
  • people with a family history of gallstones
  • Native Americans
  • Mexican-Americans
  • people who have lost weight very quickly
  • people with gastrointestinal conditions, such as Crohn’s disease people who have diabetes or insulin resistance Gallstones formed by bilirubin rather than cholesterol are less common. People who have a higher risk of developing this form of gallstone, known as a pigment stone, are:
  • people with an infection of the bile ducts

Biliary colic requires treatment, as it is likely that attacks will repeatedly happen if nothing is done.

Without removal of the gallbladder, gallstones are likely to happen again within 5 years of an episode.

The most common treatment for biliary colic is surgical removal of the gallbladder. The gallbladder is not an essential organ, and the body can function normally without it.

Surgery to remove the gallbladder is known as a cholecystectomy. There are two types called open or laparoscopic, both of which are described here:

  • Laparoscopic cholecystectomy: This is when small cuts are made in the abdomen, and a thin tube with a video camera attached is inserted. The camera shows a surgeon where to operate to remove the gallbladder.
  • Open cholecystectomy: This procedure may be needed if the gallbladder is very scarred or inflamed. The surgeon will make a 4- to 6-inch cut in the abdomen to take out the gallbladder.
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Dr. Harsh J Shah