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CLINICAL REVIEW: I J Beckingham ABC of diseases of liver, pancreas, and biliary system: Gallstone disease BMJ 2001; 322: 91-94 [Full text]

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"Biliary colic"

D J D T Pinto   (21 February 2001)

"Biliary colic" 21 February 2001
D J D T Pinto, Consultant Surgeon Tyrone County Hospital Send response to journal: Re: "Biliary colic"	Dear Editor The Clinical Review on Gallstone Disease by I J Beckingham, BMJ Vol 322 January 2001, made excellent reading but continues to perpetuate words and phrases that do not convey the meaning that they ought to do. Under clinical presentation the Subheading states “biliary colic”.. The following text states quite clearly that this is not colic and “contrary to its name, the pain often does not fluctuate but persists...”. He further points out rightly that this is visceral in origin and occurs as a result of distension if the gallbladder due to obstruction. I do feel that authors and sub-editors should stop perpetuating the term biliary colic and use the simple term of gallbladder pain or biliary pain. May I suggest that the term obstructive cholecystopathy might be useful as it clearly suggests that there is an obstructive element and if the patient doesn’t improve on observation, the obstruction may lead to stasis, infection and empyema especially in the elderly and in diabetics. This term would alert clinicians to the real cause of the problem and the occasional progression to a serious infection. May I also add the same applies to renal colic which does not exist. What should be used is the term ureteric colic which perfectly describes the symptoms that the patient suffers from. There are other misnomers in clinical use but there is no excuse for perpetuating their use in this day and age. Yours Sincerely DJDT Pinto O.B.E., M.S., F.R.C.S.