What Is Biliary Colic?

The term biliary colic refers to a steady pain with extreme cramping and other specific features that is usually felt on the right side of the abdomen, just below the ribcage. It is a symptom rather than an actual disease, and is usually caused by problems with the gallbladder or the bile duct.

Effects

• The pain caused by biliary colic most commonly occurs several hours after a meal, especially a meal high in fat. It is a constant pain that worsens gradually, although it usually lasts only about an hour. In some cases, the pain may last for several hours. It may be mild or severe, and is more of a dull aching than a sharp pain. Biliary colic is not usually associated with other symptoms.

Identification

• Biliary colic is diagnosed based on a description of the pain given to a doctor. Once it has been established that you have biliary colic, it is much easier for a doctor to narrow down the possible causes of your discomfort. An ultrasound can help determine the cause of the pain, especially if it is a result of gallstones. Your doctor may also want to perform blood tests, especially if you have other symptoms (such as fever) or your pain does not go away after several hours.

Significance

• Biliary colic is most commonly caused by gallstones. Gallstones are common but most people who have them do not experience biliary colic or other symptoms. In general, gallstones are considered to be of little consequence unless they produce symptoms. A single episode of biliary colic may not require treatment other than observation, but reducing your intake of dietary fat and losing weight (if you are overweight) can make recurrent biliary colic less likely.

Considerations

• Pain or discomfort in the right side of the abdomen is not always a result of biliary colic. Your doctor may consider other problems when evaluating you for this condition. Some other conditions that can mimic biliary colic include appendicitis, liver infections such as hepatitis, and problems with the pancreas or bowels.

Prevention/Solution

• Most people who experience biliary colic have gallstones and are treated accordingly. In addition to low-fat diets and weight loss, treatments include surgery, medication and lifestyle adjustments. Laparoscopic surgery to remove the gallbladder is the most common second-line treatment; it is more effective than medications and works much more quickly. If you are unable to have surgery, your doctor may use medication that dissolves gallstones. However, the medication can be very expensive, take a long time to work, and not always be a permanent solution to the problem.