Treatment of Chronic Cholecystitis with Biliary Colic
Clinical scenario
This protocol addresses the management of biliary colic occurring in the setting of chronic cholecystitis. Pain control is the central therapeutic priority.
Treatment approach (partial)
Biliary colic in chronic cholecystitis is treated primarily with nonsteroidal anti-inflammatory drugs. Spasmolytics may be added to address smooth-muscle spasm, and for severe or refractory symptoms, opioid analgesia is an additional option. The full structured regimen — including specific agent selection, sequencing, and further measures — is available in the complete protocol.
References
- Biliary colic should be treated with nonsteroidal anti-inflammatory drugs (e.g. diclofenac, indomethacin).
- In addition, spasmolytics (e.g. butylscopolamine) and for severe symptoms, opioids (e.g. buprenorphine) may be indicated.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as diclofenac (e.g. 50–75 mg I.M.), ketoprofen (e.g. 200 mg I.V.) or indomethacin (e.g. 50 mg I.V. or 2 × 75 mg suppositories) have analgesic effects on biliary colic.
- Best suited might be buprenorphine, because it appears to contract the sphincter Oddi less than morphine.
View source ↗