Biliary colic

### What you need to know A 30 year old woman presents to her general practice with abdominal pain. It started suddenly yesterday evening and lasted for a few hours, but then it came on again in the morning. She says it feels like a tight band around her upper abdomen. She had a similar, less painful, episode a few weeks ago which resolved with over-the-counter analgesia. She is otherwise healthy and has intentionally lost 5 kg in the past six weeks. This article outlines how to assess and manage a patient with suspected biliary colic in primary care. Areas covered include criteria for referral, investigations, and discussion of management options. Abdominal pain is a common presenting symptom with many causes, as outlined in box 1. Gallstone pathology is an important differential. Box 2 describes the spectrum of clinical syndromes that can arise from gallstones. Box 1 ### Differential diagnoses in a patient presenting with epigastric/right upper quadrant painRETURN TO TEXT Box 2 ### Spectrum of clinical syndromes caused by gallstonesRETURN TO TEXT