Gallstones are common, but when they begin causing repeated episodes of abdominal pain, timely treatment becomes crucial—especially in patients with diabetes.
Here is a real case shared by Dr. Rajeev Kapoor, highlighting the importance of early intervention in a 40-year-old woman with type 2 diabetes and recurrent biliary colic.
What Is Biliary Colic?
Biliary colic is the sudden, sharp pain caused when a gallstone temporarily blocks the cystic duct—the channel that connects the gallbladder to the bile duct.
The pain usually:
- Comes on suddenly
- Occurs after oily or heavy meals
- Lasts from 30 minutes to an hour
- Settles completely once the stone moves away
Many patients search for terms like:
- Gallstone pain after meals
- Biliary colic symptoms
- Gallstones in diabetic patients
- When to operate for gallstones
- Laparoscopic cholecystectomy benefits
This case explains all of these aspects in a clear, medically accurate way.
Case Presentation: Recurrent Pain in a 40-Year-Old Woman with Diabetes
A 40-year-old woman with type 2 diabetes experienced repeated episodes of right upper abdominal pain for more than six months. Her pain was:
- Sudden and sharp
- Triggered by fatty, oily meals
- Lasting 30–60 minutes
- Completely relieving between attacks
She did not have:
- Fever
- Vomiting
- Jaundice
- Persistent pain between episodes
These features strongly suggested biliary colic, a symptom of gallstones without acute infection.
Clinical Evaluation & Investigations
Physical Examination and Blood Tests
Her examination was normal. Blood tests—including liver enzymes and infection markers—were also normal.
This ruled out:
- Acute cholecystitis
- Cholangitis
- Obstructive jaundice
- Acute pancreatitis
Ultrasound Findings
Ultrasound revealed:
- Multiple gallstones
- Thin-walled gallbladder
- No bile duct dilatation
This confirmed symptomatic gallstone disease without complications, but the recurrent attacks and background diabetes increased her risk of progression.
Why Diabetes Increases the Risk
Patients with diabetes are more prone to:
- Severe gallbladder infections
- Gangrenous cholecystitis
- Delayed diagnosis due to altered pain perception
- Higher operative risks if surgery is delayed
Therefore, when gallstones start producing symptoms in diabetic patients, early laparoscopic cholecystectomy is strongly recommended.
Treatment: Early Laparoscopic Cholecystectomy
Based on her symptoms and risk factors, Dr. Rajeev Kapoor advised early laparoscopic gallbladder removal.
She underwent:
- Laparoscopic cholecystectomy
- No surgical complications
- Discharge the next day
Her gallbladder biopsy later confirmed chronic cholecystitis, which matched her history of long-standing, recurring pain episodes.
Recovery & Prognosis
After gallbladder removal, patients typically experience:
- Quick return to daily activities
- No recurrence of biliary colic
- Stabilization of digestive function over time
- Very low chance of future gallstone-related issues
This patient is expected to recover fully and resume normal life without further gallstone attacks.
Key Takeaways for Patients
- Repeated right upper abdominal pain after meals may indicate biliary colic
- Diabetes increases the risk of complications from gallstones
- Early laparoscopic cholecystectomy prevents future severe infections
- Ultrasound is the first and most important diagnostic test
- Recovery after minimally invasive surgery is usually rapid
