Biliary colic can happen when a gallstone blocks a bile duct, causing intense stomach pain. It is also known as a gallstone attack or gallbladder attack.

Many people have gallstones without realizing it because they rarely cause symptoms. But if someone experiences biliary colic, a doctor may need to remove the stones from the bile duct before removing the gallbladder.

Diet may play a part in creating gallstones, and eating a nutritious, balanced diet could help prevent them from forming.

Treatment for biliary colic usually involves surgery to remove the gallbladder, which will prevent biliary colic from returning.

People who have biliary colic will typically experience intense stomach pain due to gallstones. The pain usually comes and goes in episodes.

According to the 2016 WSES guidelines, around 10–15% of adults in high-income countries have gallstones. Each year, only 1–4% of those people will have biliary colic.

The gallbladder is an organ in the body that stores bile. The liver produces bile to help with digestion in the small intestine. This part of the intestine is connected to the stomach and absorbs nutrients from food and drink.

Chemical imbalances in the gallbladder that encourage gallstone formation can be due to higher-than-normal amounts of cholesterol or a product called bilirubin in the bile. Sometimes, small crystals develop and gradually grow into gallstones.

The liver produces bile. Bile flows down a system of bile ducts in the liver to meet at the common hepatic duct. Much of the bile flows into the cystic duct and enters the gallbladder for storage.

Biliary colic may occur if gallstones that form in the gallbladder get stuck, even temporarily, and prevent bile from leaving the gallbladder.

Learn more about bile duct obstruction.

The key symptom of biliary colic is a sudden, intense stomach pain that lasts for 1–5 hours. Pain is due to increased pressure in the gallbladder. Pain typically occurs in specific places, including:

  • the middle of the abdomen or belly
  • underneath the ribs on the right-hand side
  • the side of the body or the shoulder blade

Unlike more common stomach pain, biliary colic pain does not go away after passing wind, being sick, or going to the toilet.

Biliary colic happens when a stone blocks the cystic duct, preventing bile from leaving the gallbladder. The pain will go away once the gallstone no longer blocks the duct.

People can go for weeks or months without having a biliary colic episode. However, an episode can happen at any time of the day or night. Eating a big meal or fatty foods can often trigger it.

Learn more about the gallbladder.

Some people are more at risk of developing gallstones than others and are more likely to experience biliary colic. These groups :

  • females
  • people over 40 years old
  • people with obesity
  • 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 are less common than cholesterol gallstones. People who have a higher risk of developing this form of gallstone, known as a pigment stone, are:

Learn about gallstones in children.

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

Refined carbohydrates are foods that manufacturers have processed to remove the bran. 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.

Eating a nutritious, balanced diet containing plenty of fresh fruits and vegetables, whole-grain carbohydrates, and lean proteins can help prevent gallstones.

Learn some diet tips for a healthy gallbladder.

Biliary colic requires treatment. Otherwise, it will likely return again and again.

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

Surgery to remove the gallbladder is known as a cholecystectomy. There are two types: open or laparoscopic.

  • Laparoscopic cholecystectomy: This involves a surgeon making small incisions in the abdomen and inserting a thin tube with a video camera attached. The camera shows a surgeon where to operate to remove the gallbladder.
  • Open cholecystectomy: Surgeons carry out this procedure if the gallbladder is very scarred or inflamed. The surgeon will make a 4–6-inch cut in the abdomen to take out the gallbladder.

Anyone having surgery to remove the gallbladder will be under a general anesthetic so they will not feel any pain.

Surgeons typically prefer the laparoscopic option because a person tends to recover quicker and will not need to stay in the hospital overnight. Most people can resume their usual activities in about a week.

However, surgery is not always possible. Sometimes, medication or therapy is the preferred option.

Certain medications can dissolve gallstones, although this tends to work best on small stones.

Shock wave lithotripsy is another treatment option. This involves having an ultrasound to find the gallstones. Then, a machine will send painless shock waves through the body to break up the gallstones. It does not involve any cuts or incisions in the skin.

Learn more about gallstone surgery.

Biliary colic should go away once the gallstone has moved. If a gallstone blocks a bile duct for more than a few hours, other problems may develop.

The gallbladder can become inflamed or swollen. This can lead to damage or infection and affect the bile ducts or liver.

Jaundice is another potential complication that may occur as a result of biliary colic. This happens when a stone leaves the gallbladder but gets stuck in the common bile duct. This may prevent bile from flowing through the bile ducts leading from the liver.

It is also possible for a gallstone to block the pancreatic duct, which links the pancreas to the bile duct. If this happens, it can cause inflammation of the pancreas.

A stone blocking the common bile duct may also press on the adjacent pancreatic duct, potentially causing pancreatitis.

The pancreas is a key body organ that creates hormones and plays a part in digestion. If a blockage of the pancreatic duct or bile duct is left untreated, it can cause life threatening complications.

Surgery can also damage the bile duct. Although rare, this can cause pain and infection and may require further surgery.

Learn more about the liver and the pancreas.

People experiencing intense and lasting stomach pain should not ignore it. Biliary colic is likely to happen repeatedly, even if there are months between episodes.

Surgery to remove the gallbladder is usually effective, and using laparoscopic surgery can help ensure that a person makes a quick recovery.