Infections of the bile duct can affect the liver, damaging it to an extent where one might require a liver transplant. Hence, a case of cholangitis — a bile duct infection — should not be taken lightly, and one should seek immediate medical attention to avoid further complications, say experts.
Cholangitis refers to an infection that occurs due to an obstruction in the bile ducts — tubes that carry bile (a fluid that aids in digestion) from the liver and gall bladder to the small intestine. Dr Kavya Dendukuri, senior hepatologist & gastroenterologist, Kamineni Hospitals, Hyderabad, says, “Inflammation of the bile ducts located in the liver is referred to as cholangitis.” The condition can occur due to several reasons.
What is the most common cause of cholangitis?
Dr Pradeepta Kumar Sethy, director, gastroenterology, Medica Superspecialty Hospital, Kolkata, says that the reasons for bile duct obstruction can be benign or malignant. “One can develop cholangitis due to gallstones that get stuck in the bile duct or a biliary stricture, which refers to the narrowing of the bile duct. Very rarely, the condition can occur due to a worm entering the bile duct from the intestine. In addition, lymph nodes or other organs can also compress the bile duct, causing obstruction,” he shares.
The obstruction in the bile duct could also be malignant, resulting from cancer. “If there is an obstruction in the bile duct, it can lead to an infection due to bacteria from the foods that you eat, causing acute or ascending cholangitis. This infection can become severe and spread to the bloodstream; hence, urgent treatment is crucial,” he adds. Further, Dr Dendukuri informs that cholangitis can also occur due to certain autoimmune disorders like primary biliary cholangitis. Therefore, it is important to check the autoimmune profile of an individual before deciding the course of treatment.
Symptoms of cholangitis
Dr Dendukuri says primary sclerosing cholangitis is caused due to injury to the liver over the years. “Upon diagnosis with endoscopy, we may find that one no longer has a bile duct, which can eventually cause liver damage. There’s another acute form of cholangitis called IgG4‐related sclerosing cholangitis. This condition can develop due to genetic factors as well,” she elaborates.
Cholangitis is characterized by a triad of symptoms that include fever, abdominal pain and jaundice due to a rise in bilirubin levels. Dr Dendukuri says that bile gives stool its yellow color. “If the bile flow is obstructed, the stool color will be pale. In addition, one will also have itching all over the body, mostly on the palms and soles,” she adds.
Treatment and prevention
Cholangitis is usually treated with antibiotics. “If the condition is caused by stones, we try to remove them with ERCP (endoscopic retrograde cholangiopancreatography); we then put a stent so that the bile can flow normally,” says Dr Sethy.
Cholangitis can be cured unless it results from cancer, say experts. “If the condition has led to liver failure, the only treatment would be liver transplantation. If the bile duct is obstructed due to a benign mass, we need to operate. However, if it’s cancerous, we need to see what organs have been affected and plan the treatment accordingly,” says Dr Dendukuri.
Preventing the underlying causes is the only way to help avoid cholangitis. Additionally, early diagnosis is crucial, as the infection can spread to the rest of the body, causing sepsis, say experts. Therefore, undergoing health check-ups that include basic liver function tests and ultrasounds is vital to detect and treat any issues before they lead to cholangitis.
Takeaways
- Cholangitis refers to an infection that occurs due to obstruction in the bile ducts, which carry bile from the liver and gallbladder to the small intestine.
- The condition can develop due to benign or malignant reasons. Benign causes include gallstones, strictures and worms, while the malignant cause is cancer.
- Immediate treatment is crucial, as a delay can cause the infection to spread to the rest of the body. Severe cases can lead to liver failure, where the only treatment option is transplantation.
- Undergoing regular health check-ups to address any underlying cause is the best way to prevent cholangitis.
