Cholangitis is a bile duct system inflammation. The bile duct system carries bile from the gallbladder and liver to the small intestine. A bacterial infection generally causes it; however, in rare circumstances, it may be long-term (chronic). As a result of an autoimmune disorder, some people suffer from inflammation and cholangitis.
Cholangitis is classified into three types: primary, acute, and immune.
Primary cholangitis is often divided into two subtypes: primary biliary and primary sclerosing. The main distinction between these two types is that primary biliary cholangitis only affects the bile ducts inside the liver. Primary biliary cholangitis primarily affects women in their middle age.
The most common type of cholangitis is acute cholangitis, which is caused in the bile ducts by a bacterial infection. It most commonly affects persons between 50 and 60, and both men and women are impacted equally.
Immune cholangitis, also known as IgG4-related sclerosing cholangitis, arises when IgG4-positive cells infiltrate the biliary system.Men in their 50s and 60s are Primarily affected .
Cholangitis symptoms differ from one individual to another and can be mild or severe, including:
- Nausea and vomiting
- Yellowing of the skin and eyes (jaundice)
- Clay-colored stools
- Abdominal pain in the upper right side
- Dark urine
- Changes in alertness
- Low blood pressure
Cholangitis symptoms can resemble those of other health problems. To be sure, consult the doctor.
When to see a doctor?
Make an appointment with the doctor if you notice any worrying signs or symptoms. If you are diagnosed with cholangitis, you may be referred to a gastroenterologist or a doctor who specializes in liver diseases (hepatologist).
Cholangitis is usually caused by a blocked duct in the bile duct system. Gallstones or sludge infringing on the bile ducts is the most common cause of blockage. Autoimmune diseases, such as primary sclerosing cholangitis, may affect the system.
Other less prevalent causes of cholangitis include as follows:
- Blood clots
- Swollen pancreas
- Parasite infection
- A duct narrowing that may occur after surgery.
Cholangitis can also be brought on by:
- Bacterial backflow from the small intestine
- Infection of the blood (bacteremia)
- Test performed to examine the liver or gallbladder
If the infection is not treated, pressure will build up in your bile duct system and may spread to other bloodstream organs.
If you have gallstones, you are more likely to get cholangitis. Other risk factors include:
- Having autoimmune disorders like inflammatory bowel disease (also known as Crohn's disease).
- Recent surgical procedures involving the bile duct.
- Having human immunodeficiency virus (HIV)
- Traveling to countries that may expose you to worms or parasites.
The pain of cholangitis can be similar to the pain of gallstones. The healthcare provider will examine the patient's past health and perform a physical check to determine if they have cholangitis. They may also use other tests. One may be referred to blood tests such as:
Complete Blood Count (CBC)a
Complete Blood Count (CBC): This test detects the body's white blood cells. If people have an infection, then they may have a high white blood cell count.
Liver function tests
Liver function tests: A group of specialized blood tests that determine how well the liver functions.
Tests to determine whether you have a blood infection.
One may also be asked to have imaging tests such as:
Ultrasound (also called sonography)
Ultrasound (also called sonography): Using high-frequency sound waves, this test generates images of the inside organs on a computer screen. It is used to examine internal organs such as the liver, spleen, and gallbladder. It also monitors blood flow through various vessels. Endoscopic ultrasonography is used when the procedure is performed internally (EUS).
A CT scan can be performed using a dye that is either eaten or injected through an IV. The image produced depicts the abdomen, pelvis, and bile drainage area. It can help identify the cause of a blockage.
Magnetic resonance cholangiopancreatography (MRCP)
This test looks for any issues in the abdomen. It can reveal the presence of gallstones in the bile duct. The test does not require inserting a tube (endoscope) into the body. It creates detailed images by using a magnetic field and radio frequency.
ERCP (Endoscopic Retrograde Cholangiopancreatography)
ERCP (Endoscopic Retrograde Cholangiopancreatography): This can be used to diagnose and treat liver, gallbladder, bile duct, and pancreas diseases. It employs X-ray technology and a flexible tube with a camera and light at one end (an endoscope). The tube is then inserted into the mouth and throat. Through the tube, a dye is injected into the bile ducts. The dye allows X-rays to see the bile ducts. If necessary, this surgery might also help in the opening of the bile ducts.
Percutaneous transhepatic cholangiography (PTC)
In this, a needle is injected into the liver through the skin. In order to make the bile duct visible on X-rays, dye is injected into it. If the doctors are unable to access the bile ducts internally with an ERCP, this treatment can be utilized.
It is important to have a diagnosis as soon as possible. Individuals will most likely be hospitalized for a few days if they have cholangitis. Fluids will be given through an IV (intravenous) line inserted into a vein, and they will also be given pain relievers and antibacterial medication (antibiotics).
One may also need to drain the fluid in the bile duct to determine the source of any blockage. In most cases, this is accomplished through a technique known as ERCP (endoscopic retrograde cholangiopancreatography).
Chronic cholangitis treatment and management comprises:
- Treating symptoms
- Assessing liver health
- Bile duct opening procedures
Both acute and chronic cholangitis procedures involve:
- Endoscopic therapy
- Percutaneous therapy
- Liver transplant
Care at Medicover Hospitals
At Medicover hospitals, we have the best team of gastroenterologists and hepatologists who treat cholangitis and its severe symptoms. Our highly qualified physicians use the latest advanced diagnostic equipment and techniques to run tests, diagnose and treat cholangitis. Our specialists work with patients to track their health and treatment progress to achieve a faster and longer-term recovery.
Frequently Asked Questions
Is cholangitis life-threatening?
Acute cholangitis can be a potentially fatal (life-threatening) systemic condition that develops when the biliary tree becomes infected and becomes blocked due to many underlying etiologies.
Can cholangitis be cured?
No, primary biliary cholangitis cannot be cured, but some medications can help decrease the disease's progression and prevent complications.
How long can you live with cholangitis?
Primary biliary cholangitis can persist for years without causing symptoms. Those diagnosed with PBC have an average life expectancy in the early stages of the disease. However, if the condition is not detected early and if treatment is not started, the average life expectancy is 10 to 15 years.
What is the most common cause of cholangitis?
Cholangitis is usually caused by a blocked duct somewhere in the bile duct system. Gallstones or sludge impinging on the bile ducts are the most common causes of blockage. Autoimmune diseases, such as primary sclerosing cholangitis, might impact the system.
What are the risk factors for cholangitis?
A history of sclerosing cholangitis, gallstones, HIV, narrowing of the common bile duct, and, in rare cases, travel to areas where one may contract a worm or parasite infection are all risk factors.
Can a CT scan detect cholangitis?
In the acute setting, advancing cholangitis is often identified with ultrasonography (US) and a CT scan.
Is cholangitis painful?
Yes, cholangitis usually causes pain in the upper right of the abdomen, as the most common symptoms include pain.