Cholangitis

What is Cholangitis?

Cholangitis refers to inflammation of the common bile duct due to one or more gallstones passing from the gallbladder and becoming lodged, thus obstructing flow of bile from the liver to the small intestine.

What Causes Cholangitis?

Bile duct stones, as well as medical procedures that impact the common bile duct, are the most significant factors in developing cholangitis.

Some causes include:

• a bacterial infection
• a blockage caused by one or more gallstones in the biliary tree
• a blockage caused unintentially via manipulation during a medical procedure
• a tumor that has impacted the biliary tree

Risk Factors

An individual is more likely to develop cholangitis if any of these risk factors are present:

• a history of gallstones
• sclerosing cholangitis, a condition in which the ducts to the liver have been damaged
• HIV (human immunodeficiency virus)
• an abnormally narrow bile duct, which can be congenital (meaning the person was born with this condition)

Cholangitis poses a significant health risk, and even death, if not treated promptly. It primarily affects people in their 50s and 60s. There is no race or sex that is at a significantly greater risk of developing cholangitis.

Symptoms

Symptoms may include:

• abdominal pain in the upper right area of the gut
• fever and chills
• clay-colored stools
• dark urine
• nausea and vomiting
• jaundice (a yellow tinge that appears in the eyes and on the skin)

Pain can be intermittent, and may also spread to the back. Pains can be mild or intense, depending on the severity of the condition.

Tests

Because these symptoms are common to a number of conditions which affect the biliary tree, your doctor may prescribe several tests to determine the cause of your symptoms.

• ultrasound, which can be used to detect the presence of stones
• ERCP (endoscopic retrograde cholangiopancreatography)
• MRCP (magnetic resonance cholangiopancreatography)
• a cholangiogram or percutaneous transhepatic cholangiogram

The following blood tests may be routinely done to determine the present state of certain levels of enzymes in your bloodstream:

• blood counts, especially the white blood count as this is an indicator of infection
• bilirubin level (a pigment that is found in a person's blood and stool)
• liver enzyme and function tests

Treatment

It is important that cholangitis be addressed immediately, as complications can result which only exacerbate the condition. The pain and discomfort experienced by the person who has cholangitis can become quite severe.

• Antibiotics are frequently used to arrest the infection that occurs in the biliary tree.
• An ERCP can be done to remove stones or open strictures that may have caused cholangitis.
• Surgery is often considered in patients that do not respond to antibiotics or non-invasive procedures like ERCP.

Recovery

Once a regimen of antibiotics is begun, the person usually begins to feel better quickly. Recovery depends a lot on how quickly treatment is begun, therefore it is very important that a medical professional be consulted as soon as possible.

Complications

One possible complication is sepsis, a condition in which the body has a severe response to bacteria. Human systems become inflamed when a person has sepsis. Blood pressure drops and organs begin to shut down. Without immediate medical treatment, death could be the result. This can happen very rapidly.

Cholangitis is a condition that needs to be addressed aggressively and quickly. Whenever multiple symptoms (listed earlier on this page) occur, it is always prudent to seek medical advice immediately.