Summary about Disease
Cholangitis is an inflammation of the bile ducts, usually caused by a bacterial infection. Bile ducts carry bile from the liver and gallbladder into the small intestine. The inflammation can lead to serious complications, including liver damage, sepsis, and death if left untreated. There are different types of cholangitis, including acute cholangitis (sudden onset) and primary sclerosing cholangitis (a chronic, progressive disease).
Symptoms
Common symptoms of acute cholangitis include:
Abdominal pain (typically in the upper right quadrant)
Fever
Jaundice (yellowing of the skin and eyes)
Shaking chills
Nausea and vomiting In primary sclerosing cholangitis, symptoms may develop slowly over time and can include:
Fatigue
Itching
Abdominal pain
Jaundice
Weight loss
Causes
The most common cause of acute cholangitis is a blockage in the bile duct, often due to:
Gallstones
Tumors
Strictures (narrowing of the bile duct)
Infection from medical procedures like ERCP Primary sclerosing cholangitis has an unknown cause, but is thought to be autoimmune in nature.
Medicine Used
Treatment for cholangitis typically involves:
Antibiotics: To fight the bacterial infection. Common antibiotics used include broad-spectrum antibiotics such as piperacillin-tazobactam, ciprofloxacin, or levofloxacin, often combined with metronidazole.
Pain relievers: To manage abdominal pain.
Ursodeoxycholic acid (Ursodiol): Used to treat primary sclerosing cholangitis to improve liver function.
Is Communicable
Cholangitis itself is not communicable. It is not spread from person to person through contact or airborne transmission. The underlying infection is usually due to bacteria already present in the body.
Precautions
Since acute cholangitis is usually caused by a blockage, the precautions mainly related to preventing gallstones or other biliary problems where applicable:
Maintain a healthy weight.
Eat a healthy diet low in fat and high in fiber.
Avoid rapid weight loss.
Manage underlying conditions like diabetes. There are no known prevention strategies for primary sclerosing cholangitis.
How long does an outbreak last?
The duration of an acute cholangitis episode depends on the severity of the infection and the promptness of treatment. With appropriate antibiotic therapy and drainage of the bile duct, symptoms typically improve within a few days to a week. Primary sclerosing cholangitis is a chronic condition, and its course can vary significantly from person to person. The disease progresses slowly over many years, leading to liver damage and eventual liver failure.
How is it diagnosed?
Diagnosis of cholangitis typically involves:
Medical history and physical examination: Assessing symptoms and risk factors.
Blood tests: To check liver function, bilirubin levels, and white blood cell count.
Imaging tests:
Ultrasound: To visualize the gallbladder and bile ducts.
CT scan or MRI: To provide more detailed images of the biliary system and identify blockages.
ERCP (endoscopic retrograde cholangiopancreatography): A procedure where a scope is inserted through the mouth to visualize the bile ducts and remove blockages or take biopsies.
MRCP (magnetic resonance cholangiopancreatography): A noninvasive MRI technique to visualize the bile ducts.
Timeline of Symptoms
Acute Cholangitis:
Sudden onset: Symptoms typically develop rapidly over a few hours to a few days.
Early symptoms: Abdominal pain, fever, and chills may be the first signs.
Later symptoms: Jaundice, nausea, and vomiting may develop as the condition progresses. Primary Sclerosing Cholangitis:
Gradual onset: Symptoms may develop slowly over years.
Early symptoms: Fatigue and itching are common initial complaints.
Later symptoms: Abdominal pain, jaundice, weight loss, and complications of liver disease may appear as the disease progresses.
Important Considerations
Cholangitis is a serious condition that requires prompt medical attention.
Early diagnosis and treatment are crucial to prevent complications.
If you experience symptoms of cholangitis, seek medical care immediately.
People with primary sclerosing cholangitis require ongoing monitoring and management by a liver specialist (hepatologist).
Liver transplantation may be necessary in advanced cases of primary sclerosing cholangitis leading to liver failure.