Biliary colic: Causes and treatment
Diet may play a part in creating gallstones, and eating a more healthful diet could prevent them forming.
Treatment for biliary colic is usually surgery to remove the gallbladder, which will prevent the problem from happening again.
What is biliary colic?
The gallbladder may produce gallstones. If these block a bile duct, it could lead to biliary colic.
Biliary colic is intense stomach pain caused by gallstones. The pain can come and go in "attacks."
The gallbladder is an organ in the body where bile is stored. Bile is a substance produced by the liver that helps with digestion in the small intestine. This part of the intestine is connected to the stomach and absorbs nutrients from food and drink.
Gallstones are formed when a chemical imbalance happens in the gallbladder. This imbalance can cause high levels of cholesterol or a waste product called bilirubin in the bile. Small crystals may develop and gradually grow into gallstones.
The gallbladder is connected to the liver by openings that are known as bile ducts. If a gallstone blocks one of these ducts, it can cause biliary colic.
The key symptom of biliary colic is a sudden, intense stomach pain that lasts for 1 to 5 hours. Pain is caused by increased pressure in the gallbladder. This pain is usually felt 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 when a person passes wind, is sick, or goes to the toilet.
Biliary colic is often known as a gallbladder or gallstone attack. This is because it can repeatedly happen every time a gallstone blocks a bile duct. Pain will go away if the gallstone is no longer blocking the bile duct.
There can be weeks or months between episodes of biliary colic. An attack can happen at any time of the day or night but is often triggered by eating a big meal or fatty foods.
Eating a nutritious diet and maintaining a healthy weight can reduce the risk of developing gallstones.
Some people are more at risk of developing gallstones than others and are more likely to experience biliary colic. These groups include:
- people over 40 years old
- people who are obese
- people with a family history of gallstones
- Native 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 rather than cholesterol are less common. People who have a higher risk of developing this form of gallstone, known as a pigment stone, are:
- people with the liver condition known as cirrhosis
- people with an infection of the bile ducts
- people who have sickle cell anemia and related conditions
Biliary colic and diet
Refined carbohydrates are foods that have been processed to take the bran out. 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.
A healthful diet contains plenty of fresh fruits and vegetables, whole-grain carbohydrates, and lean proteins. Eating a balanced diet can help to prevent gallstones.
Biliary colic is usually treated with surgical removal of the gallbladder to prevent repeat occurrences.
Biliary colic requires treatment, as it is likely that attacks will repeatedly happen if nothing is done.
Without removal of the gallbladder, gallstones are likely to happen again within 5 years of an episode.
The most common treatment for biliary colic is surgical removal of the gallbladder. The gallbladder is not an essential organ, and the body can function normally without it.
Surgery to remove the gallbladder is known as a cholecystectomy. There are two types called open or laparoscopic, both of which are described here:
- Laparoscopic cholecystectomy: This is when small cuts are made in the abdomen, and a thin tube with a video camera attached is inserted. The camera shows a surgeon where to operate to remove the gallbladder.
- Open cholecystectomy: This procedure may be needed if the gallbladder is very scarred or inflamed. The surgeon will make a 4- to 6-inch cut in the abdomen to take out the gallbladder.
A person is under general anesthetic when both types of surgery are done.
Laparoscopic surgery is the preferred option because recovery is quicker and does not usually require an overnight stay in the hospital. The person will be able to carry on with normal activities in around a week.
Surgery may not be possible for all cases of gallstones that cause biliary colic. Medication or therapy may be used if this is the case.
Gallstones can be dissolved with certain medication, although this works best on small stones.
Shock wave lithotripsy is another treatment option. An ultrasound is used to find the gallstone, and then a machine sends shock waves through the body to break up the gallstone. There is no cut or incision made in the skin.
Biliary colic should pass once the gallstone has moved. If a gallstone blocks a bile duct for more than a few hours, it will cause other problems.
The gallbladder can become inflamed or swollen, which may lead to damage or infection and may affect the bile ducts or 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 the pancreas to become inflamed.
The pancreas is a key organ in the body that creates hormones and plays a part in digestion. If a blockage of the pancreatic duct or bile duct is left treated, it can cause life-threatening complications.
The bile duct can also be injured during surgery. Although a rare occurrence, this can cause pain and infection and will require further surgery.
Intense and lasting stomach pain should not be ignored. In the case of biliary colic, this condition is likely to happen repeatedly, even if there are months between attacks.
Surgery to remove the gallbladder is usually effective, and using laparoscopic surgery can help ensure that a person makes a quick recovery.