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

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.

Acute cholangitis

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

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:

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
  • Tumor
  • 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.

Risk Factors

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.

Blood cultures

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).

CT scan

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
  • Surgery
  • 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.

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Frequently Asked Questions

1. What is cholangitis?

Cholangitis is a disorder characterized by inflammation of the bile ducts, which transport bile from the liver to the small intestine.

2. What causes cholangitis?

Cholangitis is commonly caused by a bacterial infection in the bile ducts. It can also be triggered by other factors such as gallstones, tumors, or strictures (narrowing of the ducts).

3. What are the common symptoms of cholangitis?

Common symptoms of cholangitis include fever, abdominal pain (especially in the upper right side), jaundice (yellowing of the skin and eyes), nausea, and vomiting.

4. How is cholangitis diagnosed?

Medical history, physical examination, blood tests (such as liver function tests), imaging techniques (such as ultrasound, CT scan, or MRI), and occasionally endoscopic procedures like ERCP (endoscopic retrograde cholangiopancreatography) are all used to make a diagnosis.

5. What is the treatment for cholangitis?

Treatment often involves hospitalization, intravenous antibiotics to treat the infection, and procedures to relieve bile duct blockages, such as endoscopic or surgical interventions. In severe cases, a bile duct stent may be placed to keep the duct open.

6. Is cholangitis a life-threatening condition?

Cholangitis poses a risk to life, particularly if it is untreated. Serious consequences like liver abscesses or sepsis may result from it. To avoid serious problems, fast treatment and early diagnosis are essential.

7. Can cholangitis be prevented?

Preventing cholangitis often involves managing underlying conditions like gallstones or strictures. If you have risk factors, such as a history of gallbladder disease, it's important to follow your doctor's recommendations for preventive care.

8. Is cholangitis a chronic condition?

Cholangitis can be acute or chronic, depending on the underlying cause. Acute cholangitis typically develops suddenly and requires immediate treatment, while chronic cholangitis may develop over time due to ongoing inflammation or recurrent infections.

9. What is the prognosis for cholangitis?

The prognosis for cholangitis depends on various factors, including the cause, severity, and promptness of treatment. With timely and appropriate treatment, many people with cholangitis can recover fully. However, complications and a delay in treatment can worsen the prognosis.

10. Are there any long-term effects of cholangitis?

Long-term effects can vary depending on the individual and the severity of the cholangitis. Some people may recover completely, while others may experience ongoing liver problems, recurrent episodes, or complications related to bile duct damage.