What Is Cholangitis?

Cholangitis is an infection in the bile ducts, which are small tubes that carry bile from the liver and gallbladder to the small intestine. The condition usually happens when one of these ducts becomes blocked, allowing bacteria to grow and cause inflammation.

Cholangitis can become serious if not treated quickly. Early care is important to prevent the infection from spreading through the body.

Gallstones are the most common cause of cholangitis because they can block the flow of bile. Other causes may include narrowed bile ducts, tumors, inflammation near the pancreas, or infections. People who have had bile duct procedures or a history of gallstones may have a higher risk of developing this condition.

Symptoms

Symptoms of cholangitis often begin suddenly and may range from mild to severe.

Common symptoms include:

• Pain in the upper right side of the abdomen
• Fever and chills
• Yellowing of the skin or eyes
• Nausea or vomiting
• Dark urine
• Pale-colored stools
• Fatigue or weakness

In severe cases, people may feel confused, dizzy, or unusually sleepy.

How Is It Diagnosed?

Healthcare providers diagnose cholangitis by reviewing symptoms, performing a physical exam, and ordering tests to look for infection or blockage.

Blood tests can help identify signs of infection and check liver function. Imaging tests such as ultrasound, CT scans, MRCP, or ERCP may be used to view the bile ducts and find the source of the blockage. In some cases, ERCP can also be used to treat the problem during the same procedure.

How Is It Treated?

Cholangitis often requires treatment in the hospital, especially when symptoms are severe. Care usually begins with antibiotics, IV fluids, and medicines to help manage pain and infection.

If a bile duct is blocked, providers may need to open or drain the duct to restore bile flow. ERCP is commonly used to remove gallstones, place stents, or relieve pressure in the ducts. Some people may need surgery if other treatments are not successful.

When gallstones are the cause, gallbladder removal may be recommended after the infection improves. Many people recover well with prompt treatment, but delaying care can lead to serious complications.