Cholangitis Types - Ascending, Primary, Secondary Sclerosing

Cholangitis is a condition wherein the biliary tract of the individual gets infected. It is generally caused due to a bacterial infection, and may occur when the biliary duct or tract is blocked due to something like a tumor or gallstone. The infection that is caused due to this condition sometimes spreads to the liver. The risk factors for cholangitis include HIV, a history of gallstones, the bile duct narrowing, and in rare cases, those who have traveled to certain countries might catch a parasite or worm infection. We need to be aware of the fact that sclerosing cholangitis can be a life threatening disease and needs to be treated in time.
Patients suffering from cholangitis, suffer from an inflamed bile duct.

One of the most common causes of cholangitis is a bacterial infection, and in this case, it is known as an ascending cholangitis. This disease’s classic triad comprises of jaundice, fever, and pain in the upper right quadrant of the abdomen. Popularly known as Charcot’s cholangitis triad, this disease can be quite complicated. Cholangitis lenta is an infection to do with the biliary tract that is low grade. Let us have a look at the different types of cholangitis:

Bacteria cause ascending cholangitis. The main symptoms of ascending cholangitis are fever, jaundice and pain. The main source of the bacteria is a preceding choledocholithiasis, and this usually ascends from the intestines.
Primary sclerosing cholangitis is another type of cholangitis. This is basically an autoimmune cholangitis.
The third type of cholangitis is secondary sclerosing cholangitis, and this is caused due to some other reasons.

Cholangitis Symptoms

One should be aware of the cholangitis symptoms and causes so as to be able to diagnose and treat it properly. Cholangitis is usually caused due to a bacterial infection. On seeing the following cholangitis symptoms, diagnosis can be made. One symptom is abdominal pain in the upper region, especially in the middle or right upper side region. This pain usually comes and goes and is crampy, sharp or dull. The pain also moves to the back region or just below the patient’s right shoulder blade. Other symptoms include fever, chills, clay-colored stools, vomiting and nausea, dark urine, and skin yellowing (jaundice). Primary sclerosing cholangitis signs or symptoms may not be seen in the early stages. In some cases of primary sclerosing cholangitis, an abnormal blood test result may suggest that the patients liver in not functioning properly. In case of acute cholangitis or ascending cholangitis, the symptoms include abdominal pain, fever, and jaundice, and in severe cases, confusion and low blood pressure.

To sum up, the sclerosing cholangitis signs, ascending cholangitis symptoms, and autoimmune cholangitis symptoms are many. Depending on what the cause of your cholangitis is you could exhibit some of these symptoms:

Pain in the upper right side of the abdomen
Biliary colic
Biliary colic post a fatty meal
Pain near the right shoulder blade
Discomfort in the abdomen and flatulence
Nausea and vomiting
Fever
Jaundice
Itching skin
Pale stool

If you have any of these symptoms of cholangitis, it is best that you connect with your health care provider.

Cholangitis Treatment

It is important that cholangitis is diagnosed in time and appropriate treatment be administered. In the initial stages cholangitis, treatment guidelines recommend that antibiotics be used to treat the problem. In the case of primary sclerosing cholangitis treatment or autoimmune cholangitis treatment, the focus is on keeping the symptoms under control and slowing the progression of the disease. Cholangitis treatment duration depends on the severity of the problem and varies from patient to patient. Various tests are required before the doctor goes in for a treatment plan. Treatment options include
In the case of cholangitis treatment, antibiotics and medication helps ease the itching, boosts the absorption of vitamin, and helps clear any infection. Opening the bile ducts is another option. X-ray guided procedures help open any blockages in the bile duct and facilitate the flow of bile. Stents can be used to ensure that the ducts are open. In case of chronic cholangitis treatment, the patient may have to go in for a new liver. Ascending cholangitis treatment generally requires that the patient be admitted to a hospital. In case the blood pressure drops, intravenous fluids and antibiotics are administered. In case of acute cholangitis, any diet treatment is not advisable. Patients should not take anything orally in the acute stages of the disease. Hydration can be accomplished with the help of intravenous fluids.

Cholangitis Causes

So what are the causes of cholangitis? Primary sclerosing cholangitis causes are unknown. It could be caused in people who have certain immune system problems. Individuals who have a family history of sclerosing cholangitis tend to be more prone towards this disease. In the initial stages one may not notice any symptoms. Sclerosing cholangitis is only noticed when the patient goes in for some blood tests that might indicate that his/her liver is not functioning properly. Inflammatory bowel disease is also linked to primary sclerosing cholangitis, although the link has yet to be understood. One of the main causes of ascending cholangitis is bacteria, resulting in symptoms such as fever, jaundice and pain. The typical bacteria that could be responsible are as follows:

Anaerobic: Clostridium perfringens, E. coli, and bacteroides fragilis
Aerobic: Pseudomonas (post ERCP), enterobacter, streptococcus faecalis, and klebsiella.
Both anaerobic and aerobic infection could be found together.

Acute cholangitis causes could include parasites, surgery on the stomach, intestines, and gallbladder. In many cases, cholangitis could occur due to the bile duct being obstructed by gallstones or a tumor in the bile duct. On being blocked the bile duct becomes infected. To sum up, we need to understand that cholangitis, if not treated in time, can be life-threatening. Symptoms such as abdominal pain, fever, jaundice and in severe instances confusion and low blood pressure should not be neglected. In the initial stages, your doctor may recommend antibiotics and intravenous fluids as part of your treatment plan. He/she would also recommend tests to determine what the underlying problem could be, based on which further treatment could be recommended.

Submitted on January 16, 2014