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Biliary Colic

WHAT YOU SHOULD KNOW:

Biliary Colic (Inpatient Care) Care Guide

Biliary colic is severe pain in your upper abdomen caused by a gallbladder problem. Your gallbladder stores bile, which helps digest (break down) the fats that you eat. Biliary colic happens when something blocks the duct that moves bile out of the gallbladder.

Gallbladder, Liver, and Pancreas

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • Medicine used to treat your pain may cause dizziness, nausea, vomiting, sleepiness, or a rash. Medicine or shock wave treatment to break down your gallstones may leave bits of the stones in your body. These bits of stone may block your ducts again. During surgery, your bile duct or nearby organs such as your intestine may be damaged. Bile may leak into your abdomen. Even after treatment, stones may remain, or reform in your ducts and block them again.

  • Without treatment, your pain may come back, and it may get worse over time. You may have jaundice (yellow skin and eyes). If a gallstone is in your gallbladder, it may pass into your bile duct and cause a blockage. You may get an infection in your gallbladder or bile duct from the blockage. A larger stone may go into your intestine and cause a bowel obstruction. You may also develop problems in your other organs, such as inflammation of your pancreas. These infections, blockages, and inflammation can make you sick, and you may die. Talk to your caregiver if you have any questions or concerns about your condition, treatment, or care.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Eating and drinking:

Your caregiver may tell you not to eat or drink. Ask you caregiver for more information about when you can eat or drink.

An IV (intravenous)

is a small tube placed in your vein that is used to give you medicine or liquids.

Urine output:

Your caregivers may need to know how much you are urinating. Ask caregivers if they need to measure or collect your urine before you dispose of it.

Vital signs:

Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

Medicines:

  • Pain medicine: You may be given medicine to decrease or take away pain. Do not wait until the pain is severe before you take your medicine.

  • Antibiotics: This medicine will help fight or prevent an infection. Take your antibiotics until they are gone, even if you feel better.

  • Anti-spasm medicine: This medicine helps your gallbladder stop contracting, which can decrease your pain.

  • Antinausea medicine: This medicine may be given to calm your stomach and control vomiting.

  • Oral dissolution therapy: This medicine dissolves your gallstones. You may need oral dissolution therapy if your caregiver thinks surgery may be too risky for you. Only small stones can be dissolved, and it may take many months to work.

Tests:

Your caregiver may collect samples of your blood and urine for tests. You may also need any of the following tests:

  • Abdominal ultrasound: An abdominal ultrasound is a test that shows the inside of your abdomen. Sound waves show pictures of your abdomen on a TV-like screen. Your caregiver may do this test after you eat a high-fat meal. This test shows how your gallbladder is working and any blockages in your biliary system.

  • CT scan:

    • This is also called a CAT scan. An x-ray machine uses a computer to take pictures of your abdomen to look at the organs and blood vessels in your abdomen, and to check for problems and abnormal changes.

    • You may be given dye before the pictures are taken. The dye is usually given in your IV. The dye may help your caregivers see the pictures better. People who are allergic to iodine or shellfish (crab, lobster, or shrimp) may be allergic to some dyes. Tell the caregiver if you are allergic to shellfish, or have other allergies or medical conditions.

  • Endoscopic ultrasound: An endoscopic ultrasound is also called an EUS. An EUS uses sound waves and an endoscope (small, flexible tube) passed through your mouth to look inside your body. With an EUS, caregivers can see inside your liver, gallbladder, and bile duct.

  • Magnetic resonance cholangiography: During this test, pictures are taken of your biliary system to check for problems and changes. You will need to lie still during this test. Your caregiver may inject you with a dye, or ask you to drink some juice. The MRI machine contains a very powerful magnet. Never enter the MRI room with any metal objects. This can cause serious injury. Tell your caregiver if you have any metal implants in your body.

  • Liver and gallbladder scan: This test may also be called a HIDA scan. This is a test to look at your liver and gallbladder. You are given a small amount of radioactive dye in your IV. Pictures are then taken by a special scanner that can "see" the dye in your body. Caregivers look at the pictures to see if your liver and gallbladder are working normally.

  • Abdominal x-rays: Abdominal x-rays are pictures of the organs inside your abdomen. Caregivers use these pictures to look for problems such as blocked or ruptured intestines, kidney stones, or solid masses (tumors) in your organs.

Treatments:

Ask your caregiver for more information if you need any of the following:

  • Biliary drainage: This procedure is also called cholecystotomy. Your caregiver may remove fluid and stones from your gallbladder.

  • Cholecystectomy: Cholecystectomy is surgery to remove your gallbladder. Based on your symptoms, caregivers may wait to do this surgery, or you may need it right away.

  • Endoscopic sphincterotomy: You may need this surgery if your symptoms are caused by a blockage between your bile duct and your intestine. An endoscope is passed through your mouth. The ring of muscle that leads into your small intestine is widened.

  • ERCP: ERCP is also called endoscopic retrograde cholangiopancreatography. This procedure is done during an endoscopy to find stones, tumors, or other problems. Dye is put into the endoscopy tube. The dye helps your pancreas and bile ducts show up better on x-rays. If you have stones, they may be removed during ERCP. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to this dye. Tell your caregiver if you are allergic to shellfish, dyes, or any medicines.

  • Laparoscopic common bile duct exploration: A laparoscope (flexible tube with a camera on the end) is put into your abdomen. Your caregiver looks at your biliary system, and may remove stones.

  • Lithotripsy: Shock waves break apart stones in your gallbladder. You may be placed in a water bath or on a water-filled cushion. Medicine may be used to keep you drowsy during the procedure. Shock waves are sent through the water and toward the stones. The stones may break apart when the shock waves hit them.

  • Stenting: This surgery puts a stent (small tube) into your bile or cystic duct to keep it open.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of the Blausen Databases or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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