Biliary Colic

What is Biliary Colic

Biliary colic is severe pain caused by a problem with a small organ in the upper right part of your belly (gallbladder). The gallbladder stores a digestive fluid produced in the liver (bile) that helps the body break down fat.

Bile and other digestive enzymes are carried from the liver to the small intestine through tube-like structures (bile ducts). The gallbladder and the bile ducts form the biliary tract.

Sometimes hard deposits of digestive fluids form in the gallbladder (gallstones) and block the flow of bile from the gallbladder, causing biliary colic. This condition is also called a gallbladder attack. Gallstones can be as small as a grain of sand or as big as a golf ball. There could be just one gallstone in the gallbladder, or there could be many.

What are the causes?

Biliary colic is usually caused by gallstones. Less often, a tumor could block the flow of bile from the gallbladder and trigger biliary colic.

What increases the risk?

This condition is more likely to develop in:

  • Women.
  • People of Hispanic descent.
  • People with a family history of gallstones.
  • People who are obese.
  • People who suddenly or quickly lose weight.
  • People who eat a high-calorie, low-fiber diet that is rich in refined carbs (carbohydrates), such as white bread and white rice.
  • People who have an intestinal disease that affects nutrient absorption, such as Crohn disease.
  • People who have a metabolic condition, such as metabolic syndrome or diabetes.

What are the signs or symptoms?

Severe pain in the upper right side of the belly is the main symptom of biliary colic. You may feel this pain below the chest but above the hip. This pain often occurs at night or after eating a very fatty meal. This pain may get worse for up to an hour and last as long as 12 hours. In most cases, the pain fades (subsides) within a couple hours.

Other symptoms of this condition include:

  • Nausea and vomiting.
  • Pain under the right shoulder.

How is this diagnosed?

This condition is diagnosed based on your medical history, your symptoms, and a physical exam. You may have tests, including:

  • Blood tests to rule out infection or inflammation of the bile ducts, gallbladder, pancreas, or liver.
  • Imaging studies such as:
    • Ultrasound.
    • CT scan.
    • MRI.

In some cases, you may need to have an imaging study done using a small amount of radioactive material (nuclear medicine) to confirm the diagnosis.

How is this treated?

Treatment for this condition may include medicine to relieve your pain or nausea. If you have gallstones that are causing biliary colic, you may need surgery to remove the gallbladder (cholecystectomy). Gallstones can also be dissolved gradually with medicine. It may take months or years before the gallstones are completely gone.

Follow these instructions at home:

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Drink enough fluid to keep your urine clear or pale yellow.
  • Follow instructions from your health care provider about eating or drinking restrictions. These may include avoiding:
    • Fatty, greasy, and fried foods.
    • Any foods that make the pain worse.
    • Overeating.
    • Having a large meal after not eating for a while.
  • Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

Steps to prevent this condition include:

  • Maintaining a healthy body weight.
  • Getting regular exercise.
  • Eating a healthy, high-fiber, low-fat diet.
  • Limiting how much sugar and refined carbs you eat, such as sweets, white flour, and white rice.

Contact a health care provider if:

  • Your pain lasts more than 5 hours.
  • You vomit.
  • You have a fever and chills.
  • Your pain gets worse.

Get help right away if:

  • Your skin or the whites of your eyes look yellow (jaundice).
  • Your have tea-colored urine and light-colored stools.
  • You are dizzy or you faint.

Summary

  • Biliary colic is severe pain caused by a problem with a small organ in the upper right part of your belly (gallbladder).
  • Treatments for this condition include medicines that relieves your pain or nausea and medicines that slowly dissolves the gallstones.
  • If gallstones cause your biliary colic, the treatment is surgery to remove the gallbladder (cholecystectomy).

Biliary Colic, Pediatric

Biliary colic is severe pain caused by a problem with a small organ in the upper right part of your child’s belly (gallbladder). The gallbladder stores a digestive fluid produced in the liver (bile) that helps the body absorb and use fat. Bile and other digestive proteins (enzymes) are carried from the liver to the small intestine through tube-like structures (bile ducts). The gallbladder and the bile ducts form the biliary tract.

Sometimes hard deposits of digestive fluids (gallstones) form in the gallbladder and block the flow of bile from the gallbladder, causing biliary colic. This condition is also called a gallbladder attack. Gallstones can be as small as a grain of sand or as big as a golf ball. There could be just one gallstone in the gallbladder, or there could be many.

What are the causes?

This condition is usually caused by gallstones. In rare cases, a tumor could block the flow of bile from the gallbladder and cause (trigger) biliary colic.

What increases the risk?

This condition is more likely to develop in children who:

  • Are girls.
  • Have a family history of gallstones.
  • Are overweight.
  • Suddenly or quickly lose weight.
  • Eat a high-calorie, low-fiber diet that is rich in refined carbs (carbohydrates), such as white bread and white rice.
  • Have an intestinal disease that affects nutrient absorption, such as Crohn disease.
  • Have a metabolic condition, such as metabolic syndrome or diabetes.
  • Have a blood condition, such as hemolytic anemia or sickle cell disease.

What are the signs or symptoms?

The main symptom of this condition is severe pain in the upper right side of the belly. Your child may feel this pain below the chest but above the hip. This pain often occurs at night or after eating a very fatty meal. This pain may get worse for up to an hour, and it may last for as long as 12 hours. In most cases, the pain lessens within a couple of hours.

Other symptoms of this condition include:

  • Nausea and vomiting.
  • Pain under the right shoulder.

How is this diagnosed?

This condition is diagnosed based on your child’s medical history and symptoms as well as a physical exam. Your child may have tests, including:

  • Blood tests to rule out infection or inflammation of the bile ducts, gallbladder, pancreas, or liver.
  • Imaging studies, such as:
    • Ultrasound.
    • CT scan.
    • MRI.

In some cases, a child may need to have an imaging study that is done using a small amount of radioactive material (nuclear medicine) to confirm the diagnosis.

How is this treated?

This condition may be treated with:

  • Medicines to relieve your child’s pain or nausea.
  • Medicines to slowly dissolve the gallstones. It may take months or years before the gallstones are completely gone.
  • Surgery to remove the gallbladder (cholecystectomy) if your child has gallstones that are causing biliary colic.

Follow these instructions at home:

  • Give your child over-the-counter and prescription medicines only as told by his or her health care provider. Do notgive your child aspirin because of the association with Reye syndrome.
  • Follow instructions from your child’s health care provider about eating or drinking restrictions. These may include avoiding:
    • Fatty, greasy, and fried foods.
    • Any foods that make the pain worse.
    • Overeating.
    • Having a large meal following a period in which your child has not eaten for a while.
  • Have your child drink enough fluid to keep his or her urine pale yellow.
  • Keep all follow-up visits as told by your child’s health care provider. This is important.

How is this prevented?

To help prevent biliary colic, help your child to:

  • Maintain a healthy body weight.
  • Get regular exercise.
  • Eat a healthy high-fiber, low-fat diet.
  • Limit how much sugar and refined carbs he or she eats, such as white flour and white rice.

Contact a health care provider if:

  • Your child’s pain lasts more than five hours.
  • Your child vomits.
  • Your child has a fever or chills.
  • Your child’s pain gets worse.

Get help right away if:

  • Your child’s skin or eyes look yellow (jaundiced).
  • Your child has tea-colored urine and light-colored stools.
  • Your child is dizzy or he or she faints.
  • Your child who is younger than 3 months has a temperature of 100°F (38°C) or higher.

Summary

  • Biliary colic is severe pain caused by a problem with a small organ in the upper right part of your child’s belly (gallbladder).
  • Treatment for this condition may include medicines that relieve your child’s pain or nausea or medicines that slowly dissolve the gallstones.
  • If gallstones cause your child’s biliary colic, the treatment is surgery to remove the gallbladder (cholecystectomy).
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