Biliary colic – causes, symptoms & therapy

Biliary colic

Biliary colic is the name given to the classic symptoms of gallstone disease . The symptoms of biliary colic are primarily expressed through violent attacks of pain in the upper abdomen, which is triggered by gallstones in the gallbladder. This so-called colic pain can last only a few minutes, but also up to a few hours.

What is biliary colic?

Biliary colic is a typical symptom of gallstones (cholelithiasis). Women are about twice as likely to develop gallstones and biliary colic as men.

However, there have also been slim young men who have developed gallstones. In this group of people, however, the doctor could find it more difficult to diagnose them because they do not fit into the usual pattern of gallstone patients.

Biliary colic is by no means harmless. For example, it can happen that a gallstone gets into the pancreas, which can lead to life-threatening conditions.

Likewise, gallbladder colic can lead to jaundice caused by a stuck stone or acute inflammation of the gallbladder . Biliary colic should therefore be taken seriously and treated quickly by the doctor.

causes

Biliary colic is always caused by gallstones that have formed in the gallbladder over a long period of time. The actual pain is caused by narrowing of the bile duct due to trapped gallstones.With regard to the formation of gallstones, a certain predisposition is suspected, which can be paraphrased with the adjectives “fat, female, forty, fertile”. In other words, obese females over 40 who have already given birth are said to be particularly predisposed according to this description. In addition, taking birth control pills increases the risk of developing gallstones.

Gallstones occur when the bile “crystallizes” in the gallbladder and the components cholesterol or bilirubin form stone-like structures that are the cause of biliary colic.

This process can be triggered by greasy food, alcohol and sweets such as chocolate or ice cream, cabbage, hot spices, in short, biliary colic can be caused by any food that particularly stimulates the activity of the gallbladder.

When to the doctor?

If you suddenly notice severe colicky pain in the right middle and upper abdomen , a doctor should be consulted. If you feel very ill, it is best to call the emergency services immediately. Rapid medical help is also required if there are signs of an intestinal obstruction or sepsis , as a secondary disease (eg gallbladder inflammation) may have already developed. Other warning signs that indicate biliary colic are: fever, chills, vomiting and nausea. The symptoms usually increase rapidly and are clearly related to the bile.

Prompt treatment, however, can reliably rule out complications. Therefore, at the first sign of biliary colic, an appointment with the family doctor or gastroenterologist should be made. The doctor will examine the bile as part of an ultrasound examination and, if necessary, initiate treatment directly. The symptoms should then subside within a few hours to days. To avoid complications, a check-up visit is recommended after three to four days. If you regularly suffer from gallbladder problems, you should work with your doctor to determine the causes.

symptoms and course

Possible symptoms of biliary colic:

  • colicky (intermittent) pain/cramps in the upper abdomen
  • Discoloration of urine and stool

Biliary colic occurs when a gallstone becomes trapped on its way down the bile duct. Biliary colic is usually expressed by very strong, wave-like stomach cramps or cramps in the upper abdomen. This colicky pain, which can also radiate to the back and shoulders, lasts for varying lengths of time (a few minutes to several hours).

Biliary colic is often accompanied by nausea, vomiting and diarrhea. Darkening of the urine, light-colored stools and yellowing (jaundice) of the skin may also occur.

Diagnose

If there is a suspicion of biliary colic and a doctor is consulted, the doctor first conducts a detailed discussion with the patient. In this, the exact symptoms as well as the occurrence and duration of the complaints are discussed. The doctor then examines the so-called Murphy sign. Pressure is applied to the gallbladder with the fingertips. If severe pain occurs in the upper right abdomen or if the doctor can even feel the gallbladder, this indicates the presence of biliary colic.

If there are still doubts and to differentiate colic from other diseases such as inflammation of the gallbladder, a blood test can also be carried out. In the case of colic, the inflammatory values ​​remain unchanged, while the white blood cells in particular increase significantly in the event of inflammation. The rate of blood sedimentation also shows decisive changes in an inflammatory process.

An ultrasound examination can also provide information as to whether biliary colic is actually present. In this way, the condition of the gallbladder can be reliably identified. Even the smallest gallstones with a size of only 3 mm can be identified in this way. If the symptoms are due to another disease, the doctor is able to determine this. Once the underlying disease has been clearly diagnosed, appropriate therapy can be started immediately.

complications

As a rule, those affected suffer from severe abdominal pain and gallstones due to biliary colic. The pain itself is stabbing and burning and can also spread to other regions of the body. The permanent pain leads to a significant reduction in the patient’s quality of life. Those affected can also suffer from severe abdominal pain at night and have difficulty sleeping or irritability. It is not uncommon for chronic pain to lead to mental disorders or even depression. Biliary colic can also lead to various inflammations, so that treatment must take place in any case.

This is done with the help of medication. Usually there are no special complications. In severe cases, the stones can also be removed directly with an endoscope if it is not possible to do it. The stones are usually dissolved directly by medication. Possible infections are treated with antibiotics or directly prevented. If the course of the disease is positive, in most cases there is no reduction in life expectancy. Likewise, the stones can be removed by shock waves.

treatment and therapy

There are several methods of treating biliary colic. In acute cases, antispasmodic drugs and analgesics are administered to relieve pain.

As a further therapy, attempts can be made to dissolve the gallstones with the help of medication (ursodeoxycholic acid). However, this is a rather lengthy process that can put a strain on the organism. Attempts can also be made to break up the gallstones using shock wave therapy (shock wave lithotrypsy [ESWL]).

The most common method is surgical removal of the gallbladder and gallstones. Today, this method is used in a minimally invasive manner, which means that the gallbladder is removed by laparoscopy and the patient has to stay in the hospital for a maximum of 48 hours.

The gallbladder is an organ with no vital function. Therefore, the distance usually does not result in any health impairments. A repeated biliary colic is thus excluded. Gallstone patients should be equipped with fennel tea and antispasmodics in case of biliary colic. A hot water bottle can also relieve the symptoms.

Eating too rich and, above all, greasy food should be avoided. Liver function can be supported with the help of bitter vegetables such as chicory and grapefruit.

Artichokes (artichoke extract), black radish and peppermint are also good for preventing biliary colic.

Dorothy Farrar

Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.

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