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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.
"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.
Competing interests: No competing interests