Colic is defined as a severe abdominal pain
caused by spasm, obstruction, or distention of any of the hollow
viscera. And when it occurs due to gallstones that are present in gall
bladder or bile duct then it is known as gall stone colic. It is also
known as biliary colic. It is the most common symptom of gallstones.
Causes of formation of gallstones:
Gallstones are stones that form in the bile. There are several types of
gallstones and each type has a different cause.
Cholesterol gallstones
Cholesterol gallstones are made primarily of cholesterol.
They are the most common type of gallstone. Cholesterol is the
substance that liver cells secrete into bile. Cholesterol is a fat and
it do not dissolve in the bile in order to dissolve it liver secrete
bile acids and lecithin in the bile. If the liver secretes too much
cholesterol for the amount of bile acids and lecithin it secretes, some
of the cholesterol does not dissolve. Similarly, if the liver does not
secrete enough bile acids and lecithin, some of the cholesterol also
does not dissolve. In either case, the undissolved cholesterol sticks
together and forms particles of cholesterol that grow in size and
eventually form larger gallstones.
Pigment gallstones
Pigment gallstones are the second most common type of
gallstone. There are two types of pigment gallstones.
1)Black pigment gallstones, and
2)Brown pigment gallstones.
Black pigment gallstones: If there is too much bilirubin
that do not dissolve in bile, and combines with calcium, to form
pigment gallstones (so-called because it is dark brown in color). And
in this manner black pigment gallstones formed because they are black
and hard.
Brown pigment gallstones: If there is reduced contraction
of the gallbladder or obstruction to the flow of bile through the
ducts, bacteria may ascend from the duodenum into the bile ducts and
gallbladder. The bacteria alter the bilirubin in the ducts and
gallbladder, and the altered bilirubin then combines with calcium to
form pigment. The pigment then combines with fats in bile (cholesterol
and fatty acids from lecithin) to form particles that grow into
gallstones. This type of gallstone is called a brown pigment gallstone
because it is more brown than black. It also is softer than black
pigment gallstones.
Other types of gallstones: Other types of gallstones are
rare. Perhaps the most interesting type of gallstone is the gallstone
that forms in patients taking the antibiotic, ceftriaxone (Rocephin).
Ceftriaxone is unusual in that it is eliminated from the body in bile
in high concentrations. It combines with calcium in bile and becomes
insoluble. Like cholesterol and pigment, the insoluble ceftriaxone and
calcium form particles that grow into gallstones. Fortunately, most of
these gallstones disappear once the antibiotic is discontinued;
however, they still may cause problems until they disappear. Another
rare type of gallstone is formed from calcium carbonate.
Risk factors:
Cholesterol Stones:
1.Gender- More common in females then males.
2.Age- its prevalence increases with age.
3.Obesity
4.Pregnancy
5.Birth control pills and hormone therapy
6.Rapid weight loss
7.Inflammatory bowel diseases- Crohn's disease, ulcerative colitis.
8.Increase blood triglycerides.
Pigment stones-
Black pigment gallstones form whenever there is an increased load of
bilirubin that reaches the liver. This occurs whenever there is
increased destruction of red blood cells, as there is in sickle cell
disease and thalassemia. Black pigment gallstones also are more common
among patients with cirrhosis of the liver. Brown pigment gallstones
form when there is stasis of bile (decreased flow), for example, when
there are narrow, obstructed bile ducts.
Symptom:
Characteristically, biliary colic comes on suddenly or builds rapidly
to a peak over a few minutes.