Cholangitis is a chronic, life-threatening disease caused by damage to the bile ducts of the liver. Bile is instrumental in digestion and aids the body in clearing out bad cholesterol, depleted red blood cells, and other toxins. Cholangitis is classed as an autoimmune disease because the body turns on itself and attacks healthy cells. The condition develops over time and can be slowed with liver medications if caught and treated early.
When it comes to liver disease, this is a common question. Perhaps surprisingly, alcohol does not seem to be a primary cause of cholangitis. Rather, infection, genetic predisposition, smoking, and other environmental factors, or a combination of these things, generally bring about this bile duct issue.
Early on, cholangitis is largely free of noticeable symptoms, and is more commonly discovered on routine doctor visits or through general tests recommended as we get older. The early symptoms that do exist do not point specifically to the condition, and include dry eyes and mouth, itchy skin, and chronic fatigue.
The symptoms of cholangitis are shared with many diseases, making the diagnosis of the condition less than cut-and-dried. Other symptoms may include pain in the upper right abdomen, chills, fever, nausea, and vomiting, fatigue, low blood pressure, clay-colored stool, and jaundice. This final symptom is the most exclusive to liver disease and may prompt individuals to have the organ examined.
The list of potential cholangitis triggers is long, but a blockage somewhere in the biliary system is the most common cause. This blockage may be brought about by gallstones, blood clots, a parasitic infection, or another liver condition that causes swelling and tumors. People who are HIV positive, have traveled to countries where parasitic infection is prevalent, or have had recent bile duct surgery are at a higher risk of developing cholangitis.
The diagnosis of cholangitis usually involves a physical examination and blood tests including a complete blood count (CBC), liver function tests, and blood cultures.
Other tests your doctor suggests will depend on your health history and the severity of your symptoms. Your doctor may wish to see the results of imaging tests. These can include PTC, ERCP, CT scan, MRCP, and ultrasounds.
There is no easy answer to this question. If not caught early through routine tests, cholangitis diagnoses tend to follow an emergency room visit. They feel quite sick, and their symptoms rarely allow for waiting a week to make an appointment with their general practitioner. If diagnosed with cholangitis, you're likely looking at a hospital stay of a few days. Doctors generally try to treat the condition with IV fluids, pain medicine, and broad-spectrum antibiotics.
Further treatment, should your condition demand it, might include an endoscopic retrograde cholangiopancreatography (ERCP) to drain fluid from the bile duct. The doctor will insert an endoscope through the mouth into bile ducts so the doctor can see the problem on a video screen. From there, he or she can determine if a tube is needed to drain the ducts.
Your doctor will likely begin with the other, less-invasive treatments first, but cholangitis may be deemed too serious to treat with the endoscope, and surgery may be the only option. If the endoscope was unable to sufficiently remove the blockage, surgery is the next step and has a good success rate.
Recovery will, of course, vary based on the treatment you receive. In most cases, patients respond to IV fluids and antibiotics quickly and positively. Draining the bile duct takes time and will require further hospitalization. Should an individual need surgery, recovery varies from patient to patient. When dealing with the bile duct, sepsis is always the biggest concern and potential complication during and following treatment.
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