Biliary colic develops when gallstones temporarily block the cystic duct or common bile duct. Cholecystitis occurs when this obstruction is prolonged, resulting in inflammation of the gallbladder wall. The phrase ‘white, female, fat and fertile’ summarizes the main risk factors for the development of gallstones and gallbladder disease. Typical symptoms include constant pain in the abdomen on the upper right side, nausea, vomiting, and fever. Most patients usually have a history of recurrent episodes of this type of pain.
Treatment of patients with biliary colic depends on the severity of the symptoms. Acute and severe inflammation can lead to gangrene and perforation and therefore all patients in the acute phase should be hospitalized and carefully observed. Once the acute phase has passed, treatment is given to reduce inflammation, remove the obstruction, and prevent recurrence of symptoms. For persistent pain, Ayurvedic medicines such as Shank-Vati, Hingashtak-Churna, Agnitundi-Vati, Vishtinduk-Vati, Vat-Gajankush-Ras and Triphala-Guggulu are used. If investigations reveal a high degree of inflammation in the gallbladder, drugs like Shankh-Bhasma, Praval-Panchamrut, Kamdudha-Ras, Sutshekhar-Ras and Chandrakala-Ras are used. To remove obstruction from gallstones, drugs like Arogya-Vardhini, Sharpunkha (Tephrosia purpuria), Kutki (Picrorrhiza kurroa), Tamra-Bhasma, Punarnava (Boerhaavia diffusa), Kalmegh (Andrographis paniculata), Devdangri (Luffa echinata), Se they use Bhrungraj (Eclipta alba), Bhumiamalaki (Phyllanthus niruri), Yav-Kshar, Swarjika-Kshar, Surya-Kshar and Apamarga-Kshar.
To prevent recurrence of this condition, drugs like Arogya-Vardhini, Sutshekhar-Ras, and Shankh-Vati are used in low doses for long periods. Diabetes, HIV, cardiovascular disease, obesity, and prolonged fasting are known risk factors for gallbladder disease and gallstones. Other specific preventive treatment for these conditions is necessary to prevent cholecystitis and biliary colic in such patients. Triphala-Guggulu and Arogya-Vardhini are useful drugs that can achieve this purpose in patients with cardiovascular diseases and obesity. Chandraprabha-Vati can be added to the treatment of patients with diabetes. For HIV patients, drugs like Bhumiamalaki, Yashtimadhuk (Glycerrhiza glabra), and Bhrungraj can be added to other treatments to prevent gallbladder pathology.
Biliary colic and cholecystitis therefore require a judicious combination of prehospital, inpatient, and posthospital treatment. Surgery may be necessary for patients suspected of having impending perforation or other serious complications of the disease. Surgery may also be required for patients with recurring symptoms that do not respond to standard medical therapy.
