When your belly hurts, you naturally want to know what’s causing the pain. Lots of different health issues can cause abdominal pain or discomfort. Two of them are gallstones and biliary colic.
These two health problems are related but they aren’t the same. James McClenathan, MD, a surgeon with Banner - University Medicine, explained more about both of them. Understanding gallstones and biliary colic can help you prevent them and seek treatment if you notice symptoms.
What are gallstones?
“Gallstones are hardened deposits of digestive material that can form in your gallbladder, which is a small organ under your liver that stores bile. They are composed of cholesterol or bile salt crystals or a mixture of the two. They may be as small as grains of sand or as large as the whole inside of the gallbladder,” Dr. McClenathan said.
Bile helps you digest fats but when the cholesterol, bile salts and waste products it contains become unbalanced, you could get gallstones.
What causes gallstones to form?
It’s not always clear what causes gallstones, but they are more common in people with:
- A diet high in fat or cholesterol
- Obesity
- Rapid weight loss
- A family history of gallstones or biliary disease
- A blood disorder called hemolysis
Gallstone symptoms
You may have gallstones without any symptoms, which is called silent gallstones. “People often develop symptoms when the gallstones try to escape from the gallbladder,” Dr. McClenathan said.
If you have symptoms, you might notice nausea, bloating or discomfort in the upper right abdomen.
What is biliary colic?
Biliary colic is a symptom caused by gallstones. It happens when a gallstone temporarily blocks the bile duct, leading to sudden, intense, cramping pain. Eating a heavy or fatty meal can trigger this pain when the gallbladder contracts to release bile.
“Pain is typically in the right upper abdomen but may radiate to the back, shoulder or even the chest. People who get biliary colic usually have gallstones that cause symptoms,” Dr. McClenathan said.
The pain may last from 30 minutes to a few hours. It eases up when the bile duct isn’t blocked anymore.
How do symptoms compare?
With gallstones, you might not have any pain, or you might have mild discomfort that comes and goes over time as well as nausea and bloating. You probably won’t notice anything that causes symptoms.
With biliary colic, you’ll have sudden, severe pain that lasts for hours and then stops. You might realize that the pain follows a fatty or heavy meal.
It’s possible to have both health issues.
How are gallstones and biliary colic diagnosed?
A health care provider will probably order an abdominal ultrasound if they think you might have gallstones. A CT scan can also show gallstones but an ultrasound is the first-line test. “An ultrasound is painless and noninvasive,” Dr. McClenathan said. “About 95% of gallstones will show up on ultrasound.”
“If you have symptoms of gallstones but nothing shows up on ultrasound, your provider may order a nuclear medicine test called a HIDA scan to evaluate your gallbladder function,” Dr. McClenathan said.
Biliary colic is diagnosed based on symptoms and imaging.
Biliary colic and gallstone treatment options
If you have gallstones but don’t have symptoms, you probably don’t need to treat them.
If a gallstone tries to escape, you may have severe pain in the right upper abdomen or back. “Most people seek attention in an emergency room and most of the time surgeons will recommend removing the gallbladder right away,” Dr. McClenathan said. That procedure is called a cholecystectomy and you can live a normal life without your gallbladder.
If you have biliary colic and notice symptoms after fatty or heavy meals, talk to your health care provider. You may also need gallbladder removal surgery, but it can be a planned operation if your symptoms are mild.
When should you see a health care provider?
It’s important to seek medical attention for:
- Persistent or severe abdominal pain.
- Yellow skin or eyes (jaundice).
- Nausea or vomiting that doesn’t improve.
“A stone that escapes the gallbladder can pass into the ducts that drain the liver into the intestine. If the duct becomes blocked, you could develop jaundice or pancreatitis. Both of those conditions require urgent medical attention,” Dr. McClenathan said.
Preventing gallstones and biliary colic
Gallstones and biliary colic can’t always be prevented. But it may help to:
- Eat a balanced diet that’s low in fat and cholesterol
- Maintain a healthy weight
- Lose weight gradually, not quickly
- Work with your doctor to create a care plan to help prevent biliary colic episodes
The bottom line
Gallstones and biliary colic are closely related, but they have differences in their symptoms and treatment options. Knowing the symptoms and triggers of each can help you decide when to seek care.
If you suspect you have gallstones or biliary colic or have any unexplained abdominal pain, don’t hesitate to reach out to a Banner Health expert for guidance.
