Obstruction in the bile ducts: everything you need to know

Obstruction in the bile ducts is a fairly common pathology. The bile ducts are the ducts that allow the passage of bile from the liver to the gallbladder and small intestine.

There are different types of bile ducts. In general, they are divided into intrahepatic (within the liver) and extrahepatic. The extrahepatic, in turn, are two. One comes from the right side of the liver and one comes from the left. Both come together in one.

In addition, there is the bile duct, which is the one coming from the gallbladder. When the bile duct and the duct formed with the two extrahepatic ones join, the tube begins to be called bile duct or common bile duct. In this article we explain why these ducts can be blocked and what consequences this fact has.

What is bile duct obstruction?

Obstruction in the bile ducts, as its name suggests, consists of one of these ducts becoming blocked. This causes the bile to be retained in the liver and begin to accumulate. Bile is a liquid that contains cholesterol, bile salts, and waste products, such as bilirubin.

Bile plays a key role in digestion. The bile salts that make it up help digest the fats present in food in the small intestine. So when a bile duct obstruction occurs, digestion may be impaired.

But also, the fact that bile accumulates in the liver causes the level of bilirubin in the blood to increase. This substance can act toxic in the body.

The liver and the bile ducts have an intrinsic relationship, so the involvement of one of the structures compromises the other.

Symptoms that appear

Symptoms of bile duct obstruction are variable. In some cases they appear acutely. However, other people experience the signs progressively over years.

They can be caused by the accumulation of bile or by the alteration of the digestive process that takes place as a result. As we have mentioned, bile is necessary for fats to be digested. In the same way, it allows certain essential vitamins to be absorbed.

According to the professionals of Amita Health, one of the most common signs is jaundice. It consists of the skin and eyes staining a yellowish color. It is a situation that derives from the accumulation of bilirubin.

Bilirubin is also what tends to color stools. Therefore, when it accumulates in the liver and does not reach the intestine, the stool turns pale in color. Similarly, urine may appear cloudy.

Most of the people who suffer from obstruction in the bile ducts experience pain in the upper right side of the abdomen. Nausea, vomiting and even fever may appear. Furthermore, the accumulation of bile acids also leads to widespread itching.

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Causes of obstruction in the bile ducts

As explained in an article published in the Medical Encyclopedia, there are multiple causes of bile duct obstruction. The most common are gallstones, which we will explain in more detail in the next section.

Another cause is tumors in any of the ducts. It may even be that pancreatic cancer leads to obstruction in the bile ducts. This is because the common bile duct runs alongside this organ.

In some cases there is an inflammatory process of the airways or the formation of cysts inside. In the same way, certain scars derived from some surgery cause the problem.

Among the inflammatory processes it is important to highlight hepatitis. Hepatitis is a pathology that consists of inflammation of the liver. It is usually caused by a viral infection.

What are gallstones?

American College of Gastroenterology explains that gallstones They are small stones that form inside the gallbladder. This happens because cholesterol tends to precipitate and concentrate. In general, bile salts counteract this fact, dissolving it.

However, the process can be altered. Numerous factors influence the development of the calculations. It seems that being a woman, being obese or suffering from hemolytic anemia are determining factors. Hemolytic anemia is one that is produced by excess destruction of red blood cells.

These gallstones will try to be expelled from the gallbladder. Once they advance, they lead to a blockage in the bile ducts.

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Risk factor's

The main risk factor for bile duct obstruction is having or currently having gallstones. Similarly, any type of intervention related to the liver or gallbladder can increase the probability.

Pancreatic diseases are also associated. We have previously mentioned pancreatic tumors, but they can also be secondary to pancreatitis. Bile or liver tumors are another risk factor.

How is bile duct obstruction diagnosed?

There are several tests that help diagnose bile duct obstruction. However, the first thing is to do an extensive physical examination.

In some cases, the gallbladder or liver may be palpable. Observe if the patient has jaundice or if you have other symptoms.

The second step is usually a blood test. With this test you can check if there is any damage to the liver (transaminases are elevated) or if the bilirubin is very high. Alkaline phosphatase is also a very useful parameter.

If bile duct obstruction is suspected, abdominal ultrasound may be necessary. In some cases, computed tomography is also used. Other tests that are usually used are the following:

  • Magnetic resonance cholangiopancreatography (MRCP).
  • Endoscopic retrograde cholangiopancreatography (ERCP).
  • Percutaneous transhepatic cholangiogram (PTCA).

Available treatments

There are different ways to treat bile duct obstruction depending on the cause. The goal is to remove whatever is causing the clog. One of the most widely used techniques is endoscopic retrograde cholangiopancreatography (ERCP).

Before we have indicated it as a diagnostic method, but it also serves to treat. As explained in National Institute of Diabetes and Digestive and Kidney Diseases, is a procedure that combines endoscopy and x-ray to treat bile duct and pancreatic problems.

However, in some cases it is necessary to resort to surgery. Especially if the cause is a tumor or gallstones. People who are very prone to bile stones can get better if their gallbladder is removed.

Gallstones are the most common cause of bile duct obstruction.

Possible complications

Obstruction in the bile ducts can lead to complications. Especially in those cases in which an adequate treatment is not established. For example, an infection by accumulation of bacteria, called ascending cholangitis.

Another common complication is cholecystitis. It consists of inflammation of the gallbladder. This can also lead to infection or even rupture of the gallbladder, which is life-threatening.

Prevention and recommendations

There are certain ways to reduce the risk of bile duct obstruction, although they are not always preventable. Gallstones are linked to obesity. That is why it is recommended to maintain an adequate weight and watch your diet.

For this it is important to increase the consumption of foods rich in fiber. It is also recommended to reduce the intake of saturated fats and sugars. It is essential to go to the doctor whenever any signs or symptoms appear.

Obstruction in the bile ducts is very common

What we must bear in mind is that this pathology is very common. This is because it has multiple causes, from the formation of gallstones to tumors.

It is important to know the symptoms of bile duct obstruction so that it can be identified quickly. The longer it takes to establish treatment, the more risk there is complications appear.