Biliary colic: Information & biliary colic specialists

14.11.2023
Leading Medicine Guide Editors
Author
Leading Medicine Guide Editors

In biliary colic, gallstones disrupt the drainage of the bile ducts. The bile ducts try to break down the stone by contracting. Biliary colic is very painful and can last up to five hours. Treatment usually involves dissolving or crushing the stones. Surgery may be necessary for very large gallstones.

Here you will find further information as well as selected specialists and centers for biliary colic.

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Brief overview:

  • What is biliary colic? A blockage of the bile ducts caused by gallstones, which is perceived as very painful. The pain is caused by muscle contractions as the body tries to move the stones along.
  • Causes: If gallstones are present, they can be pushed into the bile ducts by increased production of bile after heavy, fatty meals.
  • Symptoms: Severe cramp-like, wave-like pain in the right and middle upper abdomen, possibly accompanied by nausea, belching and flatulence. Biliary colic can last up to five hours. Further complications may occur.
  • Diagnosis: Gallstones can be detected by ultrasound. An examination of the bile ducts using ERCP leads to very precise results; gallstones can also be removed in the process.
  • Treatment: Depending on the size of the gallstones and the exact cause, treatment may vary: Dissolving medication as well as painkillers, shock wave therapy and, in individual cases, surgical removal of the gallbladder are among the options.

Article overview

What is biliary colic?

Biliary colic is caused by trapped gallstones in the bile ducts. The muscles in the walls of the bile ducts try to move the stones by contracting. The patient experiences cramp-like pain in the right upper abdomen. The pain can radiate to the right shoulder and back.

The symptoms can last up to five hours.

Causes of biliary colic

The gallbladder is located in the gallbladder cavity behind the liver in the right upper abdomen. The liver produces bile, which the intestines need for digestion. The main function of the gallbladder is to collect this bile and release it through the bile duct into the duodenum when food is ingested.

There the bile emulsifies the food pulp. The gallbladder is equipped with several sphincter muscles that regulate the outflow of bile through contractions.

In some people, gallstones develop which disrupt the outflow of bile. The gallbladder produces more fluid due to heavy, fatty food. It has to be released into the intestine in order to process the chyme. This bile secretion flushes the gallstone into the bile duct, where it remains in front of the bile outlet.

The biliary system tries to release the bile and the gallstone into the intestine by contracting the bile walls. These contractions cause a cramp-like pain in the patient, which is known as biliary colic.

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Gallstones form in the gallbladder and bile ducts and can cause biliary colic © Henrie | AdobeStock

Symptoms of biliary colic

Severe, cramp-like, wave-like pain is the main symptom of biliary colic. They are mainly localized in the right and middle upper abdomen, but also in the back and shoulder. The pain may be accompanied by

A biliary colic lasts between 15 minutes and 5 hours. The gallstone is usually excreted as a result of biliary colic.

Those affected often feel a strong urge to move during a biliary colic. Movement facilitates the removal of gallstones.

As a rule, the bile ducts remain irritated for several days after a biliary colic.

Biliary colic can lead to serious complications, including

How is biliary colic diagnosed?

Gallstones, the cause of biliary colic, can be easily visualized using an ultrasound examination(sonography). The examiner feels

  • the gallbladder,
  • bile ducts and
  • liver and
  • liver and usually also the pancreas

using a transducer.

Endoscopic retrograde cholangiopancreatography(ERCP) is primarily performed if gallstones are suspected in the bile ducts. In addition to the visualization

  • of the bile ducts,
  • gallbladder and
  • of the pancreatic duct

the doctor can also use it to remove stones or widen the opening of the bile duct.

How is biliary colic treated?

Biliary colic can be treated in various ways, depending on what caused it and the size of the gallstones.

Do not eat for 24 hours after a biliary colic. Afterwards, make sure you eat a healthy diet rich in fiber.

In the case of mild biliary colic, dissolving medication containing artificial bile acid is prescribed. The gallstones must not be larger than five millimetres and must be free of calcium. The patient is also given medication to relieve cramps and pain. As soon as the stones recede, the biliary colic subsides.

Stone fragmentation with shock waves(ultrasound wave treatment) is also possible. The fragments of the gallstones are then dissolved with medication.

In the case of biliary colic caused by larger gallstones, which also occur repeatedly, surgery is necessary. Removal of the gallbladder (cholecystectomy) also eliminates the symptoms.

Gallbladder removal is a minimally invasive procedure. Only four small incisions are required to insert the instruments. Gas is then used to inflate the surgical area so that the individual structures can be separated from each other.

After the operation, small sutured incisions remain, which are barely visible after a while.

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