What is Biliary Colic?

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  • Written By: Mary McMahon
  • Edited By: O. Wallace
  • Last Modified Date: 09 December 2018
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Biliary colic is the most common symptom of gallbladder disease, appearing in over three quarters of patients who develop symptoms. It takes the form of an upper abdominal pain which can last for half an hour or more, with some patients experiencing up to five hours of usually steadily increasing pain. In fact, the term “colic” is a bit of a misnomer, because colic is a pain which waxes and wanes, rather than remaining consistent.

This symptom occurs when the bile ducts are blocked suddenly by a gallstone. Fluid starts to back up into the duct or gallbladder, causing distension and pain, and the duct also contracts violently in an attempt to push the gallstone out. The pain will persist until the gallstone is cleared. Typically, this type of colic has its onset in the wake of a meal, as the liver is triggered to produce more bile. Once someone experiences an episode of biliary colic, he or she is likely to do so again, because the symptom indicates that gallstones are forming.

Someone with biliary colic may experience nausea, vomiting, cramping, and chest pain. The pain from the gallbladder attack, as biliary colic is sometimes called, can radiate into other areas of the body. Because several conditions can cause similar symptoms, a doctor will usually examine and interview the patient carefully to confirm that the symptom really is biliary colic, and that it is really being caused by gallstones.


Treatment approaches usually start with management of gallstones. The patient may be given dietary recommendations which are designed to cut down on gallstones, and medications can be given to help break up the gallstones. Other medical treatments may also be utilized in an attempt to break up the gallstones so that they can be passed by the body.

If biliary colic recurs or becomes more severe, it may be necessary for the patient to have a cholecystectomy to remove the gallbladder. In this procedure, which is usually performed laparoscopically, the surgeon takes out the gallbladder so that it can no longer form gallstones or be obstructed. In the wake of a gallbladder removal, the patient may need to make some changes to his or her diet, as the lack of a gallbladder makes it more difficult to digest fats.

Abdominal pain can be a tricky and complicated symptom, as it can move around or its origins can be unclear. Patients should understand that it can take some time to narrow down and confirm the cause of abdominal pain, even though the interviews and tests may seem frustrating and time consuming. Doctors want to make sure they are diagnosing the problem correctly so that pain will be minimized in the long term.


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