Red flags & when to go in person for Biliary Colic (Gallbladder Pain) - Triage

Audience: pediatric

Biliary colic is a type of pain caused by problems with the gallbladder, often due to gallstones blocking the flow of bile. In children, this pain usually occurs in the upper right belly and can come and go. While many cases can be discussed safely through telemedicine, some signs mean your child needs to see a healthcare provider in person quickly. These include severe or worsening pain, fever, yellowing of the skin or eyes, or vomiting that won’t stop. Telemedicine can help assess symptoms, provide advice, and guide you on next steps. However, it cannot perform physical exams or imaging tests needed for diagnosis. Knowing when to seek in-person care helps keep your child safe and ensures timely treatment.

Red flags — go in person / ER

• Severe or worsening upper right abdominal pain lasting more than a few hours — go to emergency care immediately.
• Fever above 38°C (100.4°F) with abdominal pain — seek urgent medical evaluation.
• Yellowing of the skin or eyes (jaundice) — requires prompt in-person assessment.

What telemedicine can do

• Initial symptom assessment and history taking
• Providing guidance on symptom management and hydration
• Determining urgency and advising when to seek in-person care
• Answering questions about biliary colic and gallbladder pain

What telemedicine cannot do

• Physical examination of the abdomen
• Imaging studies such as ultrasound
• Blood tests or other laboratory investigations
• Emergency interventions or surgeries

What is Biliary Colic in Children?

Biliary colic happens when gallstones block the tubes that carry bile from the gallbladder. This causes pain, usually in the upper right part of the belly. The pain may come and go and often starts after eating fatty foods. Children may also feel nausea or vomiting.

Common Symptoms to Watch For

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These symptoms often improve when the gallstones move or the blockage clears.

When to Seek In-Person Medical Care

Seek urgent care if your child has:

These signs may mean complications like infection or blockage requiring prompt treatment.

How Telemedicine Can Help

Telemedicine allows healthcare providers to:

However, telemedicine cannot perform physical exams or order imaging tests needed to confirm diagnosis.

Preparing for a Telemedicine Visit

Before the visit, have ready:

This information helps the provider give the best advice.

After the Telemedicine Visit

Follow the provider's guidance carefully. This may include:

If symptoms worsen or new red flags appear, seek in-person care promptly.

How to prepare for your tele-visit

• Note the time symptoms started and their severity
• Record any fever measurements
• Observe and note any skin or eye color changes
• List any medications your child is taking
• Have a quiet space with good internet or phone connection for the visit

After your tele-visit

• Follow pain management advice given by the provider
• Keep your child well hydrated
• Watch for any worsening symptoms or new red flags
• Schedule follow-up care if recommended
• Seek emergency care immediately if red flags develop

FAQs

What causes biliary colic in children?

Biliary colic is usually caused by gallstones blocking the flow of bile from the gallbladder. This blockage leads to pain and other symptoms.

Can biliary colic go away on its own?

Sometimes the pain improves when the gallstone moves and the blockage clears. However, repeated episodes or severe symptoms need medical evaluation.

Is biliary colic dangerous for my child?

While biliary colic can be painful, it is usually not dangerous if mild. But complications like infection or persistent blockage can be serious and require prompt care.

Can telemedicine diagnose biliary colic?

Telemedicine can help assess symptoms but cannot diagnose biliary colic without physical exams and imaging tests done in person.

When should I take my child to the hospital?

Go to the hospital if your child has severe or worsening pain, fever, yellowing skin or eyes, or persistent vomiting.

Sources

1. Gallstones — MedlinePlus, U.S. National Library of Medicine.
2. Gallbladder Pain and Problems — Mayo Clinic.
3. Gallstones and Gallbladder Disease — Centers for Disease Control and Prevention (CDC).
4. Gallstones in Children and Adolescents — American Academy of Pediatrics.

This telemedicine education is for informational purposes only and is not a substitute for professional in-person medical care. If your child has severe symptoms or red flags, seek immediate medical attention.