What is biliary colic?

Biliary colic is extreme cramping pain in the right upper abdomen, the area just below the chest. The pain is caused by gallstones in the gallbladder (an organ of the digestive system) or bile ducts (small tubes that drain bile from the liver into the gallbladder and small intestines).

How does it occur?

The liver makes bile, a substance that helps to digest fats. If the bile has too much cholesterol, a solid particle forms and becomes a gallstone. Most gallstones are formed from cholesterol. Other compounds can also cause gallstones. The formation of gallstones is called cholelithiasis.

When a gallstone lodges in the bile ducts or the gallbladder, it causes abdominal pain (colic). The abdomen is the area between the chest and the pelvis.

If you are overweight and have a high level of blood cholesterol, you increase your risk of developing gallstones.

What are the symptoms?

Symptoms include:

• extreme pain that can feel like a heart attack

• stomach pain and/or nausea after meals, especially after eating heavy or high-fat meals

• yellowish eyes and skin (jaundice).

The pain can last an hour or more. Sometimes it spreads to the right shoulder or through the center of the back from the top of the breastbone.

How is it diagnosed?

To diagnose biliary colic, the doctor will review your symptoms, ask about your medical history, and examine you. He or she may use the following tests:

• Ultrasound scanning: a painless procedure in which sound waves are passed through the body. The echoes produce images on a computer screen and show the internal organs of the body.

• HIDA scan and CT scan: Sometimes stones will show up on an x-ray.

• Cholecystography: A special type of x-ray that allows the doctor to see the gallbladder clearly. Any gallstones will be seen on the x-ray as holes.

How is it treated?

Your doctor will treat biliary colic first with medicine and a low-fat diet. The doctor may give you pain relievers.

In most cases of biliary colic the stones will need to be removed surgically. Sometimes the gallbladder is removed. In some cases, especially if you are not well enough to have surgery, other options may be tried. For example, the doctor may try to dissolve the stones with medications. Or lithotripsy may be used to try to break up the stones with focused sound waves.

How long will the effects last?

Biliary colic usually continues until the gallstones causing the pain are gone.

How can I take care of myself?

Follow the treatment plan prescribed by your doctor. To take care of yourself during and after treatment, follow these guidelines:

• Lose weight if you are overweight and maintain your ideal weight.

• Eat healthy foods that are high in fiber. Avoid fatty foods.

• Avoid foods that have caused pains or other symptoms in the past.

If you have gallstones or biliary colic and are taking birth control pills, you may want to ask your doctor if you should use another method of birth control.

What can be done to help prevent biliary colic?

To prevent biliary colic, follow these guidelines:

• Avoid foods high in fat.

• Read the labels on food packages to learn the ingredients.

• Avoid fasting. Long periods of fasting can cause gallstones because the bile stays in the gallbladder too long.