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| Cholangitis, Causes, Diagnosis, Treatment, Prevention, Complications |
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 not treated properly, cholangitis can cause serious complications, ranging from disorders of 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 developing 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 part 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 go to the 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 may perform 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 patients with acute cholangitis, treatment is generally carried out in a 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 treatment, doctors may advise patients with acute or chronic cholangitis 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 vein
- Osteoporosis
- bile duct stones
- Heart cancer
Cholangitis Prevention
Prevention of cholangitis is to immediately check yourself if you suffer from bile duct stones, parasitic infections, and tumors in the bile ducts, so that they get treatment immediately.
In addition, take the following steps to lower a person's risk of developing cholangitis:
- Do not smoke
- Exercise regularly
- Eat a complete and balanced nutritious diet, 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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