Cholangitis

Cholangitis is an illness related to inflammation within the bile ducts, part of the biliary part of the digestive system in humans and many other organisms. This illness interferes with the body’s ability to digest food properly. Cholangitis may be chronic, meaning it lasts for a long time or even a lifetime, but is most often brought about by a sudden infection or physical blockage.

People with cholangitis may have many symptoms, but it is usually accompanied by abdominal pain and an overall feeling of being very ill; patients may experience fever, chills, nausea, and fatigue. The sickness may be cured via surgery or other treatments to drain and reopen clogged bile ducts and antibiotic medicines.

Background

The digestive system is the assortment of body parts and processes that allow humans and many other organisms to derive needed energy and nourishment from the food they eat. One of the many important features of the human digestive system is the biliary system, which includes ducts and organs that help to create and distribute bile when and where it is needed.

Bile is a liquid substance, usually yellowish-green, that the body produces for two important purposes within the digestive process. One purpose of bile is to break down fats from ingested food and ingest them into the body to be used or stored. The other purpose of bile is to help flush waste out of the digestive system.

Bile travels between different organs of the biliary system via small canals known as ducts. These ducts transfer bile from the gallbladder and liver into the duodenum, or small intestine. A well-functioning biliary system with healthy ducts is necessary for proper digestion. Illnesses or irregularities of this system, such as cholangitis, may lead to serious health problems.

Overview

Like any part of the body, the biliary system is susceptible to diseases and disorders. Sometimes, the bile duct system becomes inflamed, or irritated, leading to a condition known as cholangitis. Usually, this inflammation begins with a blockage somewhere in the bile ducts. The blockage may occur suddenly and acutely, or it may be an ongoing, chronic condition requiring long-term treatment.

The blockage is often caused by a gallstone, which is a hardened mass of bile that may be as small as a grain of sand or larger than a grape, or by a buildup of sludge-like material in the duct. It may also be triggered by infection, such as a blood infection or infection caused by bacteria from the small intestine leaking backwards into the bile ducts. However, many other health conditions may cause the bile ducts to become blocked or otherwise malfunction. Swelling of nearby organs, blood clots, a tumor in the region, or an infectious parasite may also impact their functioning. Sometimes, the effects of surgery or other medical procedures in the digestive system can lead to unexpected complications for the bile ducts. Blockages may also be affected by pre-existing conditions such as autoimmune disorders.

The blockage may cause a variety of problems within the biliary system, including impeding the flow of bile required for digestion and creating harmful pressure. If left untreated, a blocked bile duct could cause a variety of problems and spread inflammation or infection to other organs.

The symptoms of cholangitis may vary widely both in form and intensity, from limited nagging discomfort to debilitating medical emergencies. One of the most common symptoms is pain in the abdomen, particularly the upper right region where the biliary system is located. People with cholangitis may develop a range of other symptoms relating to the digestive system, including nausea and vomiting, dark-colored urine, and pale or gray-colored feces. Other symptoms are more general and not limited to the digestive process; these include fatigue, lack of alertness, fever, or chills. Another symptom may be jaundice, or the buildup of yellow coloration in the eyes and skin.

These symptoms are likely to indicate that something is wrong but are not in themselves enough to diagnose a person as having cholangitis. Generally, a doctor or other medical expert diagnoses cholangitis using one or more tests. Some tests measure the content and health of the blood, such as a complete blood count (CBC). More extensive tests for cholangitis include CT scans, magnetic resonance cholangiopancreatography (MRCP) tests, and sonography (or ultrasounds), which use different methods to create images of the inside of the body by which health care providers can look for blockages. Other tests, such as endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC), require that needles or tubes be inserted into the body.

If doctors detect signs of cholangitis, they typically recommend prompt or immediate treatment. Most forms of treatment involve draining unwanted material from the clogged bile duct, which may involve implantation of tubes into the bile ducts that can let material escape the body. Sometimes, doctors may use a long endoscopic tool to insert stents, or tubes that force open blocked ducts, or to remove gallstones. In very serious cases, more extensive and invasive surgical approaches may be required. During their treatment, people with cholangitis will likely need to stay in a hospital or other medical facility and may need to be given antibiotic medicine and fluids intravenously.

Cholangitis may happen to anyone, but certain factors may make a person more at risk of developing the condition. People who have a history of autoimmune diseases affecting the digestive system, or who have had gallstones, are at increased risk. In addition, people who might have been exposed to parasitic worms, or who have had medical procedures in the digestive system, are also more likely to develop cholangitis. HIV is also likely to cause cholangitis.

People who believe they may have this illness should seek medical consultation as soon as possible. Chances of successful recovery are much higher with prompt treatment and low if left untreated.

Bibliography

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“Cholangitis.” Johns Hopkins Medicine, 2023, www.hopkinsmedicine.org/health/conditions-and-diseases/cholangitis. Accessed 30 Aug. 2023.

“Cholangitis.” Medline Plus, 4 May 2022, medlineplus.gov/ency/article/000290.htm. Accessed 30 Aug. 2023.

“Gallstones.” Mayo Clinic, 2023, www.mayoclinic.org/diseases-conditions/gallstones/symptoms-causes/syc-20354214. Accessed 30 Aug. 2023.

Iftikhar, Noreen, and Youssef (Joe) Soliman. “What Is Cholangitis?” Healthline, 4 Nov. 2021, www.healthline.com/health/cholangitis. Accessed 30 Aug. 2023.

“Your Digestive System & How It Works.” National Institute for Diabetes and Digestive and Kidney Diseases, Dec. 2017, www.niddk.nih.gov/health-information/digestive-diseases/digestive-system-how-it-works. Accessed 30 Aug. 2023.