Biliary tract diseases: Information and specialists

Leading Medicine Guide Editors
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Leading Medicine Guide Editors

Biliary tract diseases are common. Many sufferers do not even notice them as they do not experience any significant symptoms. Gallstones alone, which form in the gallbladder, affect around 20 percent of all people. When symptoms do occur, pain in the right upper abdomen is a common symptom. A visit to a specialist is particularly advisable in the case of cramp-like pain.

Here you will find further information and selected specialists for biliary tract diseases.

ICD codes for this diseases: K83, K87.0

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Article overview

Definition of biliary tract diseases

The bile ducts are small so-called canalicular structures (= passing through a channel). Bile is drained through them from the liver into the duodenum.

There are a number of diseases that occur around the bile ducts. These include above all

If you have recurring complaints in the right upper abdominal region, you should consult a specialist. A specialist in gastroenterology is responsible for diseases of the gallbladder. Gastroenterology is a branch of internal medicine. It focuses on the gastrointestinal tract and its associated organs, including the gallbladder and bile ducts.

Depending on the findings, your doctor may refer you to a specialist in hepatology. Hepatology is a specialized discipline within gastroenterology. It deals specifically with diseases of the bile ducts and the liver.

Lage der Gallenblase
The location of the gallbladder below the liver © magicmine | AdobeStock

Symptoms of biliary tract diseases

Complaints in the area of the bile ducts are usually manifested by pain in the upper right section of the abdomen. They are initially very unspecific and not easy for laypeople to classify, especially because they usually occur irregularly.

If the symptoms become chronic, abdominal pain in the region of the liver is a common symptom. The pain is often mild, but occurs very regularly.

There are also very severe episodes of pain, also in the right upper abdomen. They are accompanied by nausea, sometimes fever and occasionally vomiting. If you have such severe symptoms, you may be suffering from acute biliary colic caused by gallstones.

Causes and risk factors of biliary tract diseases

The main cause of most biliary tract diseases is gallstones. They consist of various substances, such as calcium or cholesterol. In most cases, several stones occur at the same time. The size ranges from a few millimeters to several centimeters.

Many patients do not even notice that they have gallstones. They can dissolve on their own or are small enough to be flushed out again.

However, some gallstones cause problems and lead to significant discomfort.

The cause of the formation of stones is usually due to a change in the composition of the bile. Gallstones usually form in the gallbladder. When the stones migrate, they enter the bile ducts. There is a possibility of blockage of a bile duct. Bacterial infections are a major problem resulting from this.

After the age of 40, the risk of developing gallstones increases significantly. Women are up to three times more affected than men.

Obesity is considered a primary risk factor, as is the use of oestrogens as part of hormone therapy.

The formation of gallstones can also be genetically determined. A poor diet can also lead to a change in the fluid composition of the bile.

Gallenblase und Gallensteine
Gallstones in the gallbladder or bile ducts are one of the most common biliary tract diseases © Henrie | AdobeStock

Diagnosis of biliary tract diseases

Your doctor will first talk to you in detail about your symptoms and, if necessary, examine you physically. A stool sample and a blood sample are usually sent to the laboratory.

If gallstones are present, they can often be detected by certain elevated liver values in the blood sample. If your pain is associated with a fat digestion disorder, this can be seen in the stool sample.

Another examination option is sonography (ultrasound). This makes it very easy to identify gallstones, their exact location and position, their number and also their size.

ERCP (endoscopic retrograde cholangiopancreatography) is an important examination. ERCP uses a combination of endoscope and X-ray contrast medium. The doctor uses this to examine the cavities of the bile ducts and the gallbladder. Pathological changes and inflammations can thus be easily detected.

Treatment of biliary tract diseases

In the case of gallstones, your doctor will initially focus on observation, provided you are symptom-free. In the case of more frequent biliary colic, it is usually advisable to remove the gallstones so that they do not enter the bile duct.

Depending on the nature and size of the stones, it may be possible to dissolve them. Another option is to break them up from the outside using shock wave therapy. This is already being used successfully for kidney stones and is now also increasingly being used for gallstones.

Surgical removal is possible using the minimally invasive ERCP procedure with a probe. This operation is particularly suitable for individual stones located in the bile duct.

In the case of chronic inflammation of the gallbladder, the doctor will usually remove the gallbladder. You will probably also be given an antibiotic to accompany this.

If a tumor is present, the gallbladder is also removed as part of gallbladder surgery. If the tumor is malignant, additional chemotherapy may be considered.

Progression of biliary tract diseases

The course of biliary tract diseases depends primarily on the exact symptoms and the associated clinical picture. Diet also plays a role in many cases.

Gallstones are initially observed and often do not require treatment if they do not cause any significant problems. Only when the stones become lodged and cause inflammation is removal advisable. However, it is possible that new stones may form at some point.

In the case of chronic inflammatory processes, removal of the gallbladder is often necessary. As a rule, no major restrictions are to be expected in the further course of the disease.

Conclusion

Biliary tract diseases usually lead to discomfort and symptoms in the right upper abdomen. If the pain recurs or occurs in waves, you should consult a doctor.

A specialist in gastroenterology is the right person to get to the bottom of the cause of your symptoms.

References

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