Crampy abdominal pain after eating may be due to biliary colic. A number of other conditions, however, can also cause this symptom. If your pain is due to biliary colic, surgery to remove your gall bladder will likely be recommended. To correctly diagnose your stomach pain, your doctor may order a number of laboratory and imaging tests.
Causes
Stomach cramping after a fatty meal is classically the result of a condition called biliary colic, known popularly as gallstones. Cramps, however, can also occur as a result of numerous other pathological processes, including pancreatitis, peptic ulcer disease, and gastritis. Cramping may also occur as a result of an inability to digest a non-fatty component of the meal. For example, people with celiac disease can experience stomach cramping after a meal, but this is due to an inability to digest gluten protein, not an inability to digest fat.
About Biliary Colic
The classic presentation of biliary colic is in a middle-aged overweight woman with crampy, upper-right-quadrant abdominal pain that begins within a couple of hours of a fatty meal and lasts for several hours. Biliary colic, however, can present in a wide variety of patients. The cause of pain in biliary colic is a gallstone obstructing the flow of bile from your gallbladder to your small intestine. When flow is obstructed, your gallbladder is forced to expand, and it is this expansion that causes pain. The pain is worse after a fatty meal because fat causes your gallbladder to constrict much more than other types of nutrients.
Prognosis of Biliary Colic
Most of the time, biliary colic will resolve on its own, without any serious complications. Having one episode of biliary colic, however, puts a person at greater risk of developing this condition again. Additionally, the gallstones that cause colic can get lodged in other places and cause more serious consequences. For example, if a gallstones gets lodged farther away from the gallbladder, in a structure called the common bile duct, an infection called cholangitis might result. This condition can cause a person to become rapidly, critically ill. Additionally, if a gallstone escapes from the gallbladder and lodges in the small intestine, a condition called gallstone illeus, which is a type of bowel obstruction, can result. This can also be a true emergency.
Treatment of Biliary Colic
Biliary colic is usually treated conservatively if you're experiencing its first occurrence. You will be given pain medication, fluids, and, if admitted to the hospital, you will be taken off of oral food to give your bowel a rest. As one occurrence of biliary colic predicts future occurrences, however, surgical gallbladder removal -- cholecystectomy -- is usually recommended as a definitive treatment for colic.
Diagnosis
Because crampy abdominal pain can arise from many different causes, your doctor will ask you a series of questions to try to determine the quality of the pain -- colicky pain tends to be crampy, while ulcer pain tends to be sharp and boring -- what makes it better, and what makes it worse -- for example, colicky pain tends to be made worse by fatty foods -- and so on. Your doctor may also order an ultrasound, which is a kind of imaging test that allows them to see gallstones inside the gallbladder.
References
- MedlinePlus: Gallstones
- "Current Diagnosis and Treatment in Family Medicine"; Rod McKinlay, MD, & Samuel C. Matheny, MD, MPH; 2004
- Penn State College of Medicine: Biliary Colic
