Biliary Colic

Question 1

Define Biliary colic

Answer 1

Refers to intermittent right upper quadrant pain caused by gallstones

Question 2

Describe biliary colic pain

Answer 2

Pain is typically sudden,dull, and colicky in nature

The pain is typically in the right upper quadrant although it may radiate to the epigastrium and/or back

Question 3

What is the most common cause of biliary colic

Answer 3

Gallstones

Question 4

Describe how a gallstone is able to cause biliary colic

Answer 4

• The gallstone temporarily obstructs the drainage of the gallbladder, causing the pressure in the gallbladder to increase – which causes the biliary colic pain
• The gallstone is either gets lodged at the neck of the gallbladder or in the cystic duct
• The episode of pain typically lasts 30 minutes- 6 hours
• When the gallstone falls back into the gallbladder the symptoms resolve
• Pain is frequently associated with nausea and may precipitate vomiting

Question 5

Why does the consumption of fatty foods trigger biliary colic pain

Answer 5

The fatty acids stimulate the duodenum endocrine cells to release cholecystokinin (CCK), which in turn stimulates contraction of the gallbladder

Question 6

Name some of the management options to provide sympatomic relief for patients with biliary colic

Answer 6

Analgesia: Paracetamol +/- NSAIDs +/- opioid analgesia

Dietary changes: A low-fat diet may significantly reduce the number and severity of episodes

Lifestyle modifications: Weight loss, increasing exercise, low fat diet