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Biliary Colic - Symptoms, Treatment, Causes, Diagnosis

Updated on July 9, 2014

What is Biliary Colic?

This is a disease, or condition, of your gallbladder. Your gallbladder is that small organ located near your liver that is pear-shaped and stores the bile that has been secreted by your liver. It can also be a symptom of "gallbladder disease", which appears on three-fourths of the people who have symptoms of a gallbladder disease. It can happen to any gender, race, or age but is most prominent in women who are on birth control pills, women who are taking estrogen, women who are pregnant, or people who are overweight.

There are two types of biliary colic which are:

  • Cholecystitis - this is inflammation of your gallbladder
  • Cholelithiasis - this is blockage of your gallbladder

Symptoms

The main symptom of biliary colic is a steady pain in the upper abdomen that can last for thirty minutes or longer that slowly increases. There have been reports of patients having this increasing pain for as long as five hours. Even after the episode you’re your abdomen may continue to ache mildly for approximately twenty-four hours. There may be a feeling of pressure just below your breastbone in your upper abdominal area that is similar to gas accumulation. This pain will usually spread and may be felt in your shoulder blade on the right side. It will not get better when you change position or move around. These symptoms are generally caused by the presence of gallbladder stones in your bile ducts.

They may also experience:

  • Nausea
  • Vomiting
  • Cramping
  • Chest pain
  • A feeling of heaviness after eating a meal that contains fat.
  • Fasting and suddenly stopping the fast and eats a very big meal.

Causes

The main cause of having biliary colic is gallstones. When you have a gallstone it blocks one of the bile ducts and disrupts the normal flow of bile going into your intestines. The pain that a person feels from biliary colic is from the muscle cells in your bile ducts are contracting vigorously in order to try to move the stone. It could also be caused by a tumor or stricture of the bile duct that can also block the flow of bile. These gallstones occur because there is too much bilirubin or cholesterol in your bile. They could also form because of a deficiency of bile salt. Gallbladder stones can be as big as a golf ball or as small as a grain of sand. In addition there are a variety of other causes that can cause this condition. Some of them include:

  • Advancing age
  • Hereditary
  • Having diabetes
  • Weight loss that is sudden
  • Being pregnant
  • Obesity
  • Certain medications like birth control pills or estrogen pills
  • Gastrointestinal disorders
  • Having your gallbladder removed
  • Artificial feeding through a feeding tube
  • Fasting for a long period of time
  • Hemolytic diseases which are diseases in which your red blood cells are broken down too fast
  • Liver cirrhosis which is scarring of your liver
  • Bariatric surgery
  • After having an injury to your bile duct or gallbladder
  • Inflammation of your pancreas called pancreatitis
  • Inflammation of your small intestine called duodenitis
  • Esophageal spasms
  • Eating a diet that is high in fat and low in fiber

Biliary colic after gallbladder removal

After having gallbladder surgery a person can still get biliary colic if you have gallstones that are located in your bile duct. These stones that are in your bile duct can remain there for many years and may or may not cause biliary colic. There is a good chance that you will be relieved of the pain from biliary colic after having your gallbladder removed if it was caused by gallbladder diseases that were non-gallstone related or by the gallstones inside your gallbladder.

Diagnosis

When you see your physician for the pain he will take your medical history, listen to your symptoms, and do a physical examination, paying specific attention to the upper right part of your abdomen where your gallbladder and liver are located. The physician will have you undergo an ultrasound of your abdomen so they can look for gallstones.

Treatment

In order to prevent the pain associated with biliary colic and having gallstones occur you need to keep control of your diet. You need to make sure that you are avoiding meals that are high in fat. You also need to make sure that you are living a healthy lifestyle, including exercising at least thirty minutes a day. If you are giving the diagnosis of having gallstones or having biliary colic your physician may use one of the methods of treatment.

  • A prescription for pain medication to help ease the pain
  • Eating a gallbladder diet which includes foods that are high in fiber and fat free
  • If your pain becomes severe you may have to have a cholecystectomy, which is gallbladder surgery to remove your gallbladder.
  • If you have biliary colic after removing your gallbladder the physician will prescribe certain medications to help dissolve any gallstones in your bile duct.

The doctor could prescribe medication to help break up the gallstones instead of opting for surgery but this is expensive medication and it can take months, even years for the medication to work. This is why if the pain is consistent, severe, and other treatments have not worked that the physician decides on surgically removing your gallbladder. In addition, if the stones are large they will not dissolve because only small ones will dissolve.

Which treatment the physician chooses can also depend on which type of biliary colic you have.

  • Cholecystitis - usually with this type you will have severe abdominal pain so the physician will usually prescribe antibiotics and fluids If antibiotics do clear up the problem then you would have to have gallbladder surgery.
  • Cholelithiasis - if there is no symptoms that are associated with the gallbladder stone(s) your physician can give you medications that will eat away at the gallstones that are cholesterol-based but as mentioned above, the medication is expensive and can take awhile to work. If they are causing your problems the physician will do a laparoscopic cholecystectomy, which is a minor invasive surgery.

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