Hepatic colic symptoms and first aid

Hepatic colic is a typical manifestation of gallstone disease. This condition usually appears abruptly, its main manifestation is periodic pain syndrome of a paroxysmal nature.

This symptom appears due to the presence of calculi in the cavity of the reservoir. An attack of colic, symptoms and treatment are closely interrelated, since therapy depends on the severity of the manifestations.

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What is hepatic colic

This is a sudden attack of spastic pain in the right iliac region, which is a complication of exacerbation of gallstone disease. If we consider medical statistics, women suffer from this symptom a little less often than representatives of the opposite sex. In the international classifier ICD 10, this disease has its own code. Icb code – R1.4.

Since there are calculi in the gallbladder, this is a barrier to full circulation of bile. Its normal outflow does not occur. This condition provokes the appearance of sharp spastic painful sensations on the right under the ribs. The pain often radiates to the area between the shoulder blades, to the area of ​​the clavicle on the right. Usually the pain is sharp, burning in nature.

May appear under the influence of excessive psycho-emotional overload or after exhausting physical activity. As a result of such predisposing conditions, the concentration of adrenaline in the blood fluid increases, its excessive amount causes spasms in the muscular apparatus and in the vascular system. As a result, secretion stagnation occurs in the liver ducts, which contributes to the development of colic.

Causes of hepatic colic

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Colic in the liver occurs for various reasons. But the main reasons lie in a violation of the outflow of secretion in the ducts. More often, an attack appears after non-compliance with the prescribed diet for cholelithiasis, in violation of the diet.

Excessive physical overload can be the cause. In the predominant number of cases, an attack can occur when the outflow of bile is disturbed, if deposits interfere with this process. As a result, the bile ducts become clogged, pain appears.

But a common reason against which such symptoms may appear is gallstone disease. It is with gallstone disease that the function of bile is disrupted, stones can form. Liver diseases are rarely accompanied by such severe burning pains.


An attack of hepatic colic usually has pronounced symptoms. If hepatic colic develops, the symptoms are usually so severe that they cannot be ignored. Hepatic colic appears more often in men than in women, as evidenced by medical statistics. Hepatic colic in women is much less common, as in children (a child usually does not have such symptoms).

The main signs of this condition:

  • Sudden cramps, cramps in the liver. The duration of the pain attack is usually several hours. The pain is acute, cramping, its location is vague, the patient cannot specifically indicate the point where he is in pain. Another feature of this symptom is that pain can radiate to the back and collarbone, as well as to the epigastric region.
  • Another manifestation is an increase in heart rate; there are no significant changes in blood pressure.
  • Moderate vomiting occurs, it can be single or repeated. After the contents of the stomach leave the stomach, the person does not feel relief from the condition.
  • Hyperthermia is not diagnosed, and chills are also absent.
  • After an hour, the pain usually becomes very intense, after which it is constantly present for several hours.
  • In the future, the pain slightly reduces its severity, it may even stop abruptly.
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It is with pronounced pains that the clinical picture of such a condition manifests itself. The appearance of complications of glandular diseases can also provoke a similar condition.

Diagnostics, and which doctor to contact

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When this clinic appears, the patient must be extremely attentive to his health. It is important to seek qualified help as early as possible.

Only with the correct diagnosis, doctors can prescribe a competent treatment regimen. If these symptoms are present, the liver and gallbladder are examined.

Surveys involve laboratory and instrumental methods. A sampling of urine and blood fluid is carried out, the level of biochemical parameters is examined by a laboratory method.

Ultrasound examination of the liver and gallbladder is a reliable diagnostic method. Diagnosis is prescribed using radiography and, if necessary, computed tomography. Examination and treatment are carried out by narrow specialists – hepatologists or gastroenterologists.

Urgent care

When hepatic colic occurs, it is important to take measures to stop the severity of the pain syndrome. What to do, how to relieve an attack if the clinic of the disease worsens? Emergency care for hepatic colic is the relief of the severity of symptoms. It is also very important to ensure parallel expansion of the ducts by relieving muscle tension.

First aid assumes the following algorithm of actions. Take nitroglycerin in any form. One tablet or two drops of an alcohol solution is taken. When using a solution, it is better to drop it on sugar, so it will act faster.

If such measures are not enough, intramuscular injection of platifillin, altropin or papaverine should be given. You can combine the listed drugs. Intramuscular injection with the drug arpenal also helps.

To reduce the severity of pain, it is necessary to introduce aspirin or analgin. These medications can be used every four hours. A warm heating pad can be applied to the area of ​​the right hypochondrium, this will help to expand the vessels and ducts, the stones move faster. It is recommended to sit in a hot tub whenever possible.

When hyperthermia and chills appear, it is mandatory to take antimicrobial drugs or antibacterial agents prescribed by a doctor.

The main task of first aid is to eliminate the spasm so that bile can freely exit, as well as to relieve the severity of pain.

Hepatic colic treatment

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Treatment of hepatic colic consists in the use of medications that have an antispasmodic effect. These drugs include: noshpu, drotaverine, papaverine, platifillin.

In a particularly advanced situation, such drugs are recommended to be administered intramuscularly, so they are absorbed faster and begin their active action.

Another effective method, thanks to which it is possible to establish metabolism in the organs of the biliary system, is fasting throughout the entire attack. It is recommended to drink still mineral water. Additionally, allochol is taken to accelerate the excretion of bile stagnation.

Preparations for hepatic colic

All dosages and the method of application of any medication are determined only by the attending specialist after a preliminary examination and consultation. If severe pain occurs during an attack, all painkillers and antispasmodics are administered only by injection.

Therefore, it is recommended to provide first aid to the patient, put him to bed, apply a heating pad and give nitroglycerin or noshpu, then be sure to call an ambulance.

Usually, if a person suffers from gallstone disease, such attacks are not uncommon for him, therefore many patients already have the necessary drugs in their home medicine cabinet (previously prescribed by the attending specialist) and know how to behave in case of an exacerbation of the disease.

As for over-the-counter pain medications, suppositories that contain papaverine or belladonna extract are effective. Before using such funds, you should definitely read the instructions for use, since in some cases such medications may be contraindicated.

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In the event that hepatic colic develops, the symptoms are not very intense, you can use an oral solution of atropine, diluting it with cold water, as described in the instructions for use.

How to relieve hepatic colic at home

At home, with hepatic colic, you can take aspirin, noshpu or analgin. Provide the patient with bed rest. Apply a warm heating pad to the painful area. Do not eat, it is allowed to drink mineral water without gas.

It is also recommended to take a hot bath, due to this, the ducts will expand, stagnation will be eliminated.

Prevention and diet for hepatic colic

Hepatic colic is a consequence of exacerbation of gallstone disease. Therefore, in order to avoid this condition, proper nutrition should be observed. This is the best prevention of hepatic colic. During the attack, food should be absent. Further, the diet is gradually expanding. Daily consumption of easily digestible protein foods is important. You should exclude animal fats from the menu, replace them with vegetable fats. This is how the bile metabolism is gradually restored.

If the patient is overweight or is diagnosed with obesity, the menu should contain minimal carbohydrates and all of them should be easily digestible. Include greens, fruits, vegetables, berries, fermented milk products (preferably low-fat), light soups, lean meat and fish, cereals in the daily diet.

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The method of heat treatment of food is very important. It is not allowed to eat fried, fatty, salty, smoked food, sausages, spices, offal. It is recommended to cook, stew, bake. For the food to be better absorbed, it must be puree, mushy, or homogenized.

It is also important to observe fractional food intake – divide small portions into five to six times during the day. This algorithm helps the intestines to digest food faster, improves the outflow of bile.

When products rich in fiber and dietary fiber are added to the menu, the outflow of bile is improved. Also, such food helps to eliminate cholesterol. The main task of the diet with exacerbation of colic is to restore the functioning of the organs of the digestive system, liver, bile and its ducts. Also, with the help of such nutrition, you can prevent the re-development of an exacerbation of an attack.

The main preventive measures are:

  • properly adjusted nutrition,
  • moderate physical activity,
  • the ability to cope with stress and psycho-emotional stress,
  • timely treatment of chronic diseases of the digestive system.

The listed preventive measures will help relieve pain, prevent stagnation of bile, other diseases, the formation of calculi, exacerbation of gallstone disease and, as a result, an attack of colic is also among the complications.

It is important to remember about the inadmissibility of self-administration of medications not previously prescribed by a doctor. Seeing a doctor should be mandatory, since similar symptoms can accompany the development of acute appendicitis and other dangerous diseases, which only a specialist can recognize.

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Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.