Have you ever had a really bad stomach ache, right below your upper ribs, shortly after eating a fatty meal? Perhaps accompanied by nausea, it was so severe that you couldn't even move. This is what many people simply call 'gallstone pain.' Medically, we call this condition Biliary Colic. It's not actually a disease, but a symptom of an underlying condition. So today, let's talk about it.
What is Biliary Colic?
Simply put, Biliary Colic is a temporary, severe abdominal pain caused by something blocking your biliary tract - that is, your gallbladder and bile ducts. Imagine a small stone stuck in a water pipe. When we turn on the faucet, the water pressure increases and creates a lot of pressure behind the blockage, right? That's what's happening here.
Bile, a fluid produced by our liver, is temporarily stored in the gallbladder. When we eat food, especially fatty foods, it travels through the bile ducts and enters the small intestine. This helps in the digestion of fats. Gallstones are the main cause of this. When a stone gets stuck in the bile duct or where it comes out of the gallbladder, the pressure increases as the gallbladder contracts, causing severe pain.
What is the nature and location of this pain?
Biliary colic pain is a little different from other stomach aches. It has several characteristics.
| Nature of pain | Simply a description |
|---|---|
| Episodic | The pain starts suddenly, peaks, and then disappears completely within a few hours. It doesn't last for days at a time. |
| Persistent | This means that the pain doesn't come and go in waves. Once the pain starts, it stays the same for several hours without increasing or decreasing. |
| Severe | Many people describe it as a sharp, stabbing pain, like a knife, twisting, or a sharp pain. Some people find it so severe that they can't even stand up straight. |
Where do you feel the pain?
Most of the time, the pain is felt in the upper right side of the abdomen, just below the ribs. That's where the gallbladder is located. Sometimes, the pain can spread to the right shoulder or back.
Other symptoms that accompany the cough
Biliary Colic pain may be accompanied by the following symptoms:
- Nausea and vomiting
- Abdominal tenderness
- Excessive sweating (Sweating)
Difference between Biliary Colic and other serious conditions
If the pain of biliary colic does not subside within a few hours, it could be a more serious condition such as cholecystitis (inflammation of the gallbladder) or cholangitis (inflammation of the bile ducts). It is important to know the difference between these.
| Status | Main features | Important points |
|---|---|---|
| Biliary Colic | Severe pain (reducing within a few hours), nausea. | There is no fever. The pain is temporary. |
| Cholecystitis (inflammation of the gallbladder) | Continuous severe pain, fever , and rapid heartbeat. | This could be due to a gallbladder infection. Immediate medical attention is needed. |
| Cholangitis (inflammation of the bile ducts) | Right-sided abdominal pain, fever , and jaundice - which is yellowing of the eyes and skin. | This is an infection of the bile ducts. It is a very urgent and serious condition. |
The most important thing is, if your pain lasts for more than 5-6 hours, or if you have symptoms like fever, chills, and yellowing of the eyes, go to a hospital's Emergency Department (ETU) immediately.
What causes this?
As we mentioned before, the main culprit is gallstones , but there can be other causes as well.
- Gallstones: This is the cause in 90% of cases. A stone temporarily gets stuck in a bile duct, causing increased pressure and pain. The pain goes away when the stone moves around or when the gallbladder stops contracting.
- Biliary Stricture: Whether from a previous surgery or a long-term inflammatory condition, the bile ducts can become scarred and narrowed, obstructing the flow of bile.
- Biliary Dyskinesia: Sometimes the gallbladder doesn't contract properly, or the sphincter of Oddi doesn't open properly. These problems can also cause bile to build up and increase pressure.
What are the treatments for this?
When you see a doctor, he or she will examine you and perform tests, such as an ultrasound scan, to determine the exact cause. Treatment will depend on the cause and the severity of the condition.
1. Painkillers: Painkillers such as NSAIDs (Nonsteroidal anti-inflammatory drugs) are given to control pain.
2. Meal Plan: It is very important to avoid foods high in oil and fat (fried foods, fatty meats, dairy foods, cheese, butter) . Because these foods stimulate the gallbladder to contract. By reducing these, the recurrence of pain can be controlled to a great extent.
3. Stone-dissolving medications: Medications like Ursodeoxycholic acid are given to dissolve some small cholesterol stones. However, this is not suitable for everyone.
4. Endoscopy/ERCP: If a stone is stuck in a bile duct, a procedure called ERCP (Endoscopic Retrograde Cholangiopancreatography) can be used to remove the stone by inserting a tube with a camera through the mouth and passing special instruments through it.
5. Surgery: If the main cause of biliary colic is gallstones, and this condition recurs, the best and most permanent solution is to surgically remove the gallbladder (cholecystectomy). Now this is often done through a keyhole surgery called laparoscopic surgery. Therefore, there is less scarring and faster healing. There is no problem living normally without a gallbladder.
Take-Home Message
- Biliary Colic is a severe, intermittent pain in the upper right side of the abdomen. It often occurs after eating fatty meals.
- This is a warning sign of an underlying condition, such as gallstones, so never ignore it.
- If the pain persists for more than a few hours, or if symptoms such as fever or jaundice develop, go to a hospital's Emergency Department (ETU) immediately.
- Even if the pain subsides, be sure to see a doctor to find the cause and receive appropriate treatment.
- With proper treatment, this condition can be completely cured and serious complications can be prevented.
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