Cholangitis is inflammation of the bile ducts , which are the tubes that carry bile from the liver to the intestines and gallbladder. This condition can be characterized by fever, nausea, and pain in the abdomen.

Bile is a fluid needed by the body in the digestive process. Under normal conditions, the fluid will be carried by the bile duct to be stored in the gallbladder.

In cholangitis, the bile ducts become inflamed, causing them to swell and become blocked. This causes the bile that is carried by the bile ducts back into the liver and causes disturbances in that organ.

Cholangitis can occur suddenly (acute) or long-term (chronic). If you don't get proper treatment, cholangitis can cause serious complications, ranging from interference with other organs to death.

Causes of Cholangitis

Most cases of acute cholangitis are caused by a bacterial infection. However, there are several other factors that can cause cholangitis, namely:

  • Blockage by blood clots
  • Tumor
  • Parasitic infection
  • Swelling of the pancreas
  • Bile duct stones
  • Side effects of medical procedures, such as endoscopy
  • Bacteremia

Meanwhile, the cause of chronic cholangitis is not known for certain. However, it is suspected that chronic cholangitis is linked to an autoimmune disease , which is a condition in which the body's immune system attacks healthy bile ducts.

Cholangitis risk factors

Cholangitis can happen to anyone, but there are several factors that can increase a person's risk of experiencing this condition, namely:

  • Between 50-60 years old
  • Have a previous history of gallstone disease
  • Have an autoimmune disease, such as Crohn's disease or ulcerative colitis
  • Undergoing surgery or medical procedures involving the bile ducts
  • Suffering from HIV/AIDS
  • Traveling to areas where there are many cases of parasitic infections

Symptoms of Cholangitis

Symptoms of cholangitis can vary, from the general to the specific. In acute cholangitis, symptoms can appear suddenly.

Some of the symptoms that can arise in cholangitis are:

  • Pain in the upper right side of the abdomen that feels like cramping or stabbing and can come and go
  • Fever
  • Freezing
  • Nausea and vomiting
  • Dark urine
  • Paleer colored stools
  • Jaundice
  • Low blood pressure
  • Fatigue

When to see a doctor

Immediately consult a doctor if you experience the symptoms mentioned above. Examination and treatment need to be done as early as possible to prevent complications.

Cholangitis Diagnosis

To diagnose cholangitis, the doctor will ask questions about the symptoms experienced and the patient's medical history, then proceed with a physical examination.

To confirm the diagnosis, the doctor can carry out the following series of examinations:

  • Blood tests, to detect infection and find out how well the liver is functioning
  • Ultrasonography (USG) , to see the condition of the internal organs of the abdomen, such as the liver, spleen, and gallbladder
  • CT scan, to check the presence or absence of blockages in the bile ducts
  • Endoscopic retrograde cholangiopancreatography (ERCP) , to detect disorders in the bile ducts by endoscopic procedures
  • Percutaneous transhepatic cholangiography (PTCA), to detect problems in the bile ducts by injecting a contrast agent into the bile ducts

Cholangitis Treatment

Treatment of cholangitis depends on the cause. In acute cholangitis patients, treatment is generally carried out in the hospital, by giving fluids through an IV and antibiotics, such as:

  • Ampicillin
  • Piperacillin
  • Metronidazole
  • Quinolones, such as cipofloxacin and levofloxacin

In patients with chronic cholangitis, the doctor will give the drug ursodeoxycholic acid . However, it is important to remember that these drugs cannot cure chronic cholangitis, but only to relieve symptoms and prevent complications.

In addition to the above treatments, doctors may advise acute or chronic cholangitis patients to undergo the following medical procedures:

  • Endoscopic retrograde cholangiopancreatography (ECRP), to treat blockages in the bile ducts, and attach a stent to the bile duct to keep it open
  • Surgery, to remove the blocked part of the bile duct

Cholangitis Complications

If not treated properly, acute cholangitis can cause several complications, namely:

  • Collection of pus ( abscess ) in the liver
  • Kidney failure
  • Recurrent and long-lasting (chronic) cholangitis
  • Sepsis

While the complications that can occur in patients with chronic cholangitis are:

  • heart failure
  • Portal hypertension, which is high blood pressure in the portal veins
  • Osteoporosis
  • Bile duct stones
  • Heart cancer

Cholangitis Prevention

Prevention of cholangitis is to immediately go for a check-up if you have bile duct stones, parasitic infections, and tumors in the bile ducts, so that you can get treatment immediately.

In addition, take the following steps to reduce a person's risk of developing cholangitis:

  • Do not smoke
  • Exercise regularly
  • Eat complete and balanced nutritious food, and increase fiber intake from vegetables and fruits
  • Avoid consuming raw meat, because it can be a source of bacteria
  • Limiting consumption of alcoholic beverages
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