Table 1.
Definitions of biliary pain in different types of studies.
| Consensus-Based Definitions | |
| Gallstone screening studies | |
| GREPCO—Rome Group for the Epidemiology and Prevention of Cholelithiasis (1984) [39] | Abdominal pain in the last five years Duration of 30 min or more Localized in right hypochondrium and/or epigastrium |
| Chianciano population study (1994) [40] | |
| MICOL—Multicenter Italian Study on Cholelithiasis (1995) [41] | |
| Sirmione Study (1987) [44] | Same definition as [39,40,41] |
| + not relieved by bowel movements | |
| Clinical studies | |
| Ros and Zambon (1987) [42] | Steady pain in the right hypochondrium/epigastrium |
| Nausea or vomiting | |
| Duration of at least one hour | |
| Associated or not with food ingestion | |
| Unrelated to bowel movements | |
| Unassociated with discomfort at urination | |
| Heaton et al. (1991) [45] | Abdominal pain attacks during the last year |
| Duration of 30 min or more | |
| Localized in the upper abdomen | |
| Forces one to stop activities, lie down, or take analgesics | |
| Martinez de Pancorbo et al. (1997) [46] | Abdominal pain in the right hypochondrium and/or epigastrium |
| Forces one to lie down or take analgesics | |
| Mertens et al. (2010) [43] | One or more of upper abdominal pain, nausea, and vomiting |
| Clinical practice guidelines | |
| NICE—National Institute for Health and Care Excellence (2014) [9] | No recommendation due to lack of research |
| UMHS—University of Michigan Health System (2014) [14] | Severe episodic pain |
| Localized in right upper abdominal quadrant/epigastrium | |
| May be nocturnal | |
| Occasionally postprandial | |
| Possibly tenderness | |
| EASL—European Association for the Study of the Liver (2016) [10] | Episodic attacks of severe pain |
| Localized in right upper abdominal quadrant/epigastrium | |
| Radiation to the right back or shoulder | |
| Duration of at least 15–30 min | |
| A positive response to analgesics | |
| Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland, Royal College of Surgeons (2016) [15] | Pain localized in right upper quadrant/epigastrium |
| Frequently radiating to the back | |
| Duration of several minutes to hours | |
| Often occurring at night | |
| Dutch Society for Surgery (2017) [11] | Biliary colic |
| Radiating pain clockwise to the back | |
| A positive response to analgesics | |
| German Society for Digestive and Metabolic Diseases and German Society for Surgery of the Alimentary Tract (2018) [12] | Pain attacks localized in right upper quadrant/epigastrium |
| Duration of more than 15 min | |
| Possible projection to back and right shoulder | |
| Possible nausea and vomiting | |
| Data-based Definitions in Prospective Studies | |
| Prospective cohort studies | |
| Shabanzadeh et al. (2017) [48] | Pain localized in the epigastrium |
| Moderate to extreme intensity | |
| Duration of hours | |
| Need for analgesics | |