Biliary Colic

What is biliary colic? 

Biliary colic is intermittent and often severe epigastrium and / or right upper quadrant pain secondary to temporary obstruction of the cystic duct with gallstones. At times, pain is also reported to occur between the scapula. These pain episodes typically occur at approximately 15-20 minutes after eating and tend to abate over several hours. 

What are gallstones 

Gallstones are are hardened deposits that can form in the gallbladder. They come in varied sizes and are made up of either cholesterol or pigment stones. The stones are not necessarily a problem. Its possible to have gallstones in the gallbladder, yet not develop any symptoms from it. In this case, the stones do not need to be treated. However, when the stones block the gallbladder or the tubes (ducts) that carry digestive fluids from the gallbladder to the small bowel (duodenum), the walls of the gallbladder or ducts may become inflamed with subsequent bacterial infection. Prompt presentation to a surgeon for treatment is warranted. 

Risks of developing gallstones

• Family history of gallstones 

• Female above 50 years old 

• Excessive fat consumption

• Obesity / overweight 

• Pregnancy 

• Recent rapid weight loss 

How is biliary colic treated?

A consultation with your GP and subsequent referral to a surgeon will ensure that your symptoms are appropriately assessed and treated 

Conservative measure for biliary colic 

Has a limited role as the management of biliary colic is primarily surgical. 

This may involve dietary change; to consume low fat or no fat diet 

Surgical management for biliary colic: 

Surgery is usually performed with a keyhole approach with aims to remove the gallbladder +/- perform a contrast test to check for presence of choledocholithiasis (stones in bile ducts), abnormal anatomy, and assist with the identification of ductal injury.