Gallstensattacker

Gallstensattacker, or biliary colic, are acute episodes of intense abdominal pain caused by temporary obstruction of the biliary tract by gallstones. The pain most often arises from the gallbladder or cystic duct when a stone blocks the flow of bile. The episodes are typically triggered by a fatty meal and last from 15 minutes to several hours. Pain is usually located in the right upper quadrant or epigastrium and may radiate to the right shoulder or back. Nausea, sweating, and sometimes vomiting may accompany the pain. Fever and persistent tenderness suggest complications such as cholecystitis or choledocholithiasis and require urgent evaluation.

Diagnosis relies on clinical presentation and imaging. Abdominal ultrasound can detect gallstones and show gallbladder wall thickening or sludge. Blood tests may show mild elevation of liver enzymes or white blood cell count if inflammation is present; in uncomplicated biliary colic these are typically normal.

Treatment focuses on symptom relief and prevention of recurrence. During an attack, analgesia with NSAIDs or acetaminophen and antiemetics are used; fluids if needed. If attacks recur or stones are known to be present, elective cholecystectomy (surgical removal of the gallbladder) is usually recommended to prevent further episodes. Some patients may be managed with medical therapy or endoscopic removal if there is ductal stone.

Complications include choledocholithiasis (stone in the common bile duct), acute cholangitis, and pancreatitis. Risk factors for gallstones include female sex, obesity, age, rapid weight loss, and certain metabolic conditions.