Biliary Colic – Causes, Symptoms & Treatment

Bilious attack

biliary colic refers to an inflammation of the gallbladder, which is triggered by stones formed there. Patients suffer from pressure and inflammatory pain and often from febrile concomitant diseases that can arise from the body’s defense reaction to the internal inflammation of biliary colic.

What is biliary colic?

Biliary colic is usually diagnosed after the appearance of severe pain in the area of the upper abdomen, which, however, can radiate to other parts of the body. The causes are gallstones formed in the gallbladder even before the first symptoms appear, which often hinder the natural activity of the gallbladder after a fatty meal in such a way that inflammation occurs.

Due to the obstruction of this process, in which the gallbladder tries to pump bile into the stomach for digestion and can be blocked by the stones, there is a strong irritation and sudden pain.

Even stones that have rubbed against each other in the gallbladder for a long time and thus irritated the gallbladder can trigger biliary colic, which in this case is chronic without rapid treatment.

If one of the stones slips into the exit of the gallbladder and thus blocks the activity of the organ, biliary colic is also triggered. Often biliary colic is also accompanied by inflammatory reactions such as chills, fever or, in some cases, even yellowing of the skin.


A biliary colic, which is triggered by formed gallstones, can have several causes. Once stones have formed, there is an increased risk of developing biliary colic.

When and why these gallstones form is not exactly known, so in principle anyone can be affected by biliary colic. Particularly susceptible, however, seem to be people who eat irregularly and thus prevent regular stress and kneading of the gallbladder.

The probability of the formation of gallstones and thus the risk of developing biliary colic increases here.

Symptoms, complaints and signs

Biliary colic can be associated with sudden severe [[upper abdominal pain| pain in the upper abdomen]], but it can also be slowly announced by a non-specific feeling of pressure and fullness in the upper abdomen. The pain can be felt under the right costal arch or in the middle of the abdomen, it can radiate on the right side in the back and shoulder.

Characteristic of biliary colic is that the pain most often comes and goes in waves, similar to labor pains, which they also resemble in strength. The colic is caused by the contraction of the gallbladder and bile duct to excrete the blocking gallstone. Due to the severe pain, those affected have an urge to move to relieve the pain.

Exercise is also useful because it can help excrete the gallstone. The duration of biliary colic can range from 15 minutes to several hours. In addition to the severe pain, other symptoms such as flatulence, bloating, belching, nausea and vomiting may be added.

Biliary colic can occur again and again as long as gallstones are present in the gallbladder. Sometimes only the surgical removal of the gallstone or gallbladder helps in the long run if many small gallstones are present in the gallbladder.


Depending on how the biliary colic was first triggered, it may be that the symptoms subside or persist chronically. For example, if high-fat food was the trigger, the pain may be relieved once the bile has been fully pumped into the stomach and the gallbladder contraction has stopped.

However, if a patient has been suffering from larger gallstones for some time, which cause inflammation or blockage of the gallbladder and thus biliary colic due to abrasion, the stones must be removed as quickly as possible.


Acute biliary colic can lead to various complications and secondary diseases. First of all, there is a risk that the accumulated bile leaks and enters the abdomen. Such gallbladder perforation can lead to severe inflammation of the internal organs and, in extreme cases, provoke life-threatening blood poisoning. The gallbladder itself can also become inflamed and trigger a so-called cholecystitis.

The gallstones rub against each other and cause severe pain in the upper abdomen and sometimes also a gallbladder empyema. Chronic gallbladder inflammation can promote gallbladder carcinomas, which are associated with jaundice, unwanted weight loss and the typical symptoms of biliary colic. There may also be complications in the treatment of biliary colic.

The painkillers and antispasmodics used can cause a number of side effects, such as allergic reactions and eye or headaches. In conjunction with other drugs (for example, the cancer and rheumatic drug methotrexate), the prescribed preparations can cause interactions.

The surgical removal of gallstones can lead to injuries to the gallbladder. If the gallbladder itself is removed, metabolic disorders can temporarily occur, which, however, should subside after a few days to weeks.

When to go to the doctor?

In case of sudden severe pain in the chest or stomach region, a doctor should be consulted immediately. It is an acute condition of the body in which immediate help is necessary. If cramping symptoms occur in the area of the right half of the body, a doctor is needed who must initiate an examination and treatment. The middle and upper abdomen are the regions that attract attention due to unexpected pain attacks and must be examined by a physician.

If there is a closure of the intestinal activity, medical care is also necessary. If the person concerned suffers from very severe complaints, an should be called. So that no further complications occur, it should be kept calm until its arrival. In addition, the instructions of the rescue service must be followed.

In case of symptoms such as vomiting, diarrhoea, chills or nausea, a doctor should be consulted. Fever or a general feeling of illness are signs that must be controlled and medically clarified.

In most cases, there is an improvement in health within a few days of medical care. If this does not occur, a further check-up is necessary. If the bile pain occurs at repeated intervals, this is considered unusual. It is advisable to determine the causes of this with a .

Treatment & Therapy

There are several options for treating biliary colic, depending on what triggered the biliary colic and how large the gallstones are.

Stones smaller than five millimeters can be treated by administering dissolving drugs containing artificial bile acid. If the treatment is successful, the biliary colic subsides as soon as the stones recede and dissolve.

Stones that have slipped into the conductor connecting the stomach must be removed as soon as possible, usually using an endoscope inserted through the stomach. However, this treatment option is only possible if the biliary colic was triggered by constipation and the stone can be reached by probe.

If the stones are located in the gallbladder and they are too large to be dissolved by medication, it is also possible to treat the biliary colic by surgically removing the gallbladder.

This method is also recommended in the case of severe suppuration or infection, since it is assumed here that even if the biliary colic subsides within a few years, renewed inflammation must be expected. The procedure can be performed either through an incision in the abdominal wall or through a small puncture, the so-called buttonhole method.

Those who do not want to undergo an operation have the option of having larger stones shattered by external ultrasound wave treatment and using medication to dissolve the fragments and thus treat biliary colic.

Outlook & Forecast

The prognosis for biliary colic depends on the cause of the symptoms, the size of any gallstones and their location. In principle, the patient has a good prognosis when seeking medical treatment. This worsens as inflammation develops or treatment is refused. In severe cases, the patient even faces a life-threatening condition.

In the case of small gallstones, the symptoms can be alleviated within a few days with medication. The drugs cause regression and dissolution of the stones. The patient is then considered symptom-free after a few weeks.

In the case of larger gallstones or foreign bodies that are difficult to access, surgical removal is carried out. This process comes with the usual risks and side effects. If no complications occur, the patient can also be discharged from the treatment after a few weeks as cured.

Large stones or gallstones located directly in the gallbladder may require surgical removal of the gallbladder. This intervention is comparatively more extensive and associated with greater consequences. Nevertheless, the prognosis is good here too. As an alternative to surgery, the patient can opt for ultrasound treatment followed by drug therapy. With this treatment plan, the chances of recovery are equally good.


Those who have acute symptoms of biliary colic can prevent inflammation by eating a low-fat and gentle diet. People with gallstones also often take bile-acid-containing drugs for prevention, which dilute the bile and thus prevent biliary colic.


As part of the aftercare, a regular follow-up by the doctor is recommended. As part of these follow-ups, the physician will, among other things, inquire about dietary habits and, if necessary, make suggestions for changes. Basically, the diet must be changed.

A diet low in saturated fat and high in polyunsaturated fat is considered ideal. The patient should maintain close contact with a nutritionist during follow-up care and constantly adapt the diet to the symptom picture. Follow-up care may also include taking alternative remedies.

Various choleretic medicinal plants have an antispasmodic effect on the bile ducts and contribute to an improvement of the symptoms. For example, the patient can try peppermint, turmeric, dandelion or wormwood. The intake of natural remedies should always be monitored by a doctor so that any side effects can be detected at an early stage.

After biliary colic, follow-up examinations must take place every three to six months. If there are no further complaints, the distances can be gradually increased. As part of the follow-ups, blood values are measured and, if necessary, ultrasound examinations are carried out. In addition, the doctor will always carry out an anamnesis in order to better assess the course of the disease.

What you can do yourself

A biliary colic should be clarified medically in any case. In most cases, medical treatment can be supported by simple measures and various home remedies.

In the case of regular bile complaints, a change in diet is recommended. High-fat or high-sugar foods are a common trigger for colic and should be avoided for the time being. Healthier is a balanced diet with fruits, vegetables, whole grains and lean meat and fish. In general: eat slowly and drink enough water with every meal. Standing snacks should be avoided. Dietary measures also help against and high cholesterol levels – both possible causes of biliary colic.

Symptomatic can be treated against colic with various medicinal plants. The artichoke reduces bloating and bloating, while , fenugreek and garlic relieve abdominal cramps. Immediately after eating, the acute symptoms can be prevented with herbal teas (such as turmeric,cumin or celandine) and hot abdominal wraps.

If, despite these measures, severe symptoms occur, it is necessary to go to a doctor with biliary colic. Perhaps the symptoms are caused by a medication or there is a serious condition that must be treated immediately.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.