Cholangitis

Inflammation in the bile duct system causes Cholangitis. The bile duct system is responsible for carrying bile from the liver and gall bladder into the duodenum.

Generally, it is caused by a bacterial infection and occurs suddenly. However, in other cases, it could be long-term and chronic. Another section of people develops inflammation and cholangitis due to an autoimmune condition.

Types

There are four types of cholangitis:

• Acute cholangitis or ascending cholangitis
• Primary sclerosing cholangitis (PSC)
• Secondary sclerosing cholangitis (SSC)
• Recurrent pyogenic cholangitis (RPC)

Signs and Symptoms

Early symptoms of chronic cholangitis are:

• Exhaustion
• Dry mouth
• Itchy skin
• Dry eyes

The symptoms of long-term chronic cholangitis are:

• Swollen ankles and feet
• Pain in the upper right side
• Hyperpigmentation
• Muscle pain
• Night sweats
• Pain in the joints or bones
• Bloating
• Fat deposits in the skin near the eyes and eyelids
• Fat deposits in the palms, knees, elbows, and soles of the feet
• Weight loss
• Greasy, clay-coloured bowels
• Mood swings and problems with memory

Causes

There are several causes for the development of cholangitis. Sometimes, the cause is unknown. When diagnosed as chronic, cholangitis could be an autoimmune disease that results in inflammation.

Over a period, the inflammation can cause scars or the development of hard tissue within the bile ducts. This narrows and hardens the ducts and blocks smaller ducts.

Acute cholangitis is caused by:

• A tumour
• Bacterial infection
• Blockages
• Gallstones

Cholangitis can also develop due to environmental causes, such as:

• Bacterial, fungal, viral, or parasitic infections
• Chemicals
• Smoking

Risk Factors

If you already suffer from gallstones, your risk for cholangitis is greater. Other risk factors are:

• Suffering from inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis
• Having had medical procedures in the region of the bile duct
• Being diagnosed with human immunodeficiency virus (HIV)
• Travelling to areas with high exposure to parasites or worms

Prevention

Generally, it is not possible to prevent cholangitis. However, since this condition is largely caused due to the presence of gallstones in the bile ducts, it could be possible to prevent the development of gallstones.

To prevent gallstones from developing, the following can be done:

• Eat a healthy diet comprising sufficient soluble and insoluble amounts of fibre
• Exercise
• Quit smoking

Diagnosis

Your doctor can test for cholangitis by performing certain scans and tests. The blood tests include:

• Complete Blood Count (CBC)
• Blood culture
• Kidney function tests
• Liver function tests

Through scans, the blood flow inside the liver and other parts of the abdomen show up. These scans are:

• X-ray
• MRI scan
• Ultrasound
• CT scan

TREATMENT

Treatment given for acute and chronic cholangitis varies because their causes are different. Treatment also varies upon how early the diagnosis is made. If untreated, both these kinds of cholangitis can cause serious complications.

If treating acute cholangitis, it is important to undergo treatment as early as possible. For this, your doctor may advise a 10-day course of antibiotics.

Procedures to be done in the hospital may also be advised, such as:

• Intravenous fluids
• Bile duct drainage

To treat chronic cholangitis, however, no medications are available, except for the drug ursodeoxycholic acid, which protects the liver by enhancing bile flow. However, it does not treat cholangitis.

Treating chronic cholangitis includes:

• Management of Symptoms
• Monitoring Liver Function
• Procedures that Open Blocked Bile Ducts

Common procedures for both acute and chronic cholangitis are:

• Liver transplant
• Endoscopic therapy
• Surgery
• Percutaneous therapy

If you suffer from the side effects of cholangitis, they can be treated in these ways:

• Take Vitamins A, D, E, and K supplements
• Take Vitamin D and calcium supplements for osteoporosis
• Your doctor will monitor your high blood pressure reading and treat it

Preparing for Your Appointment

There’s a lot of ground to cover during your first appointment with your doctor, so it would help if you go well-prepared.

You can do this in these ways:

• Write down the symptoms you’ve been experiencing, any stresses you’ve had, and any important personal information
• List out all the medications you’re on and the supplements you take
• Take along with you a family member or friend who will provide the necessary information you might forget to provide
• List the questions you want to ask the doctor

Management

Medical Management

In the absence of a cure for primary biliary cholangitis, there are medications that can retard the progression of this disease and lead to further complications. They are:

• Ursodeoxycholic acid (UDCA): This is the generally used first. It helps reduce liver scarring and overall liver function.
• Obeticholic acid (Ocaliva): When given by itself or in combination with Ursodeoxycholic acid, it aids in improving liver function.
• Fibrates: When taken with Ursodeoxycholic acid, they work to get rid of itching and liver inflammation.
• Liver transplant: When all medications fail, a liver transplant is the last recourse a specialist takes for a successful long-term outcome.

Lifestyle & Others

Though medications may help you improve, there are certain lifestyle changes you should incorporate now to prevent any further complications. These are: opting for low-sodium foods, excluding raw shellfish from your diet, exercising so that you don’t have bone loss, and giving up alcohol.

Complications

Cholangitis, if not treated, can lead to serious health problems. Potential complications include:

• Liver problems: Cholangitis can cause scarring of the liver (cirrhosis). Your liver function can become slow or even fail. It may lead to liver swelling, high blood pressure, and a greater risk of liver cancer.
• Gallstones: Pain and infections can be caused by gallstones. Blocked bile may harden into gallstones.
• Enlarged spleen: When the liver isn’t working properly, it can’t filter out wastes and toxins. This causes worn-out blood cells to accumulate in the spleen, making it enlarge.
• Enlarged veins: Increased pressure in the liver can strain the veins in the stomach. This may result in enlarged, ruptured veins and can also trigger bleeding.
• Blood infection: Acute cholangitis can lead to sepsis (a blood infection). This may be life-threatening if not treated.

WHY Rela Hospital

Advantages/Expertise

If you are diagnosed with cholangitis, you need to have the best liver specialists in India attend to you. Where better can you be sure of finding them than in a dedicated hospital for liver diseases?

Welcome to the Dr Rela Hospital, Chennai, where you can depend not just on the expertise of Dr Rela himself, a liver specialist, but also his team of specialists.

This hospital has been specially set up to all liver ailments apart from liver cholangitis disease, has been set up on a 36-acre estate in Chromepet, Chennai. With 450 beds, 130 critical care beds and 14 operating rooms, apart from state-of-the-art diagnostics, you’re in the hands of the best in cholangitis treatment in Chennai and other related liver diseases.

Already, this hospital has made a name for itself in the realm of cholangitis liver transplant in Chennai by treating several patients successfully. With a high success rate and complimentary nursing care, treating chronic liver disease treatment in India has now become dependable and easily available.

When are diagnosed with liver cholangitis disease, you can’t waste time. Avail of the best treatment in this field. Now available at Dr. Rela Hospital, Chennai.