Biliary Tract Disorders

Biliary tract disease refers to continuous blockage of the biliary tract, usually caused by gallstones. However, there are certain rare biliary tract diseases such as Cholangiocarcinoma, which may be caused by a tumor wf the common bile duct. Some of the prominent symptoms of biliary tract disease include right upper abdominal pain, nausea, dark urine, and jaundice.ithin the common bile duct or Pancreatic cancer which is caused by a tumor that puts pressure on the exterior of the common bile duct. Some of the prominent symptoms of biliary tract disease include right upper abdominal pain, nausea, dark urine, and jaundice.

Biliary atresia

As per the current estimates, Biliary atresia affects around one in every 15,000 live births. In this condition, as the bile ducts of the liver do not have normal openings, the bile gets trapped in the liver, resulting in jaundice and cirrhosis. Biliary atresia occurs is frequently diagnosed in neonates. Infants might remain jaundiced for six weeks or more soon after birth and will have pale stool and dark urine. This condition can prove to be extremely fatal if it is left untreated.

There is no curative therapy for biliary atresia. The surgical treatment, Kasai Portoenterostomy, helps in restoring the flow of bile and prevents the onset of jaundice. If the treatment is successful, the patient achieves a 10-year survival rate. Even if patients have an early surgery, 60 percent to 80 percent of them ultimately tend to develop end-stage biliary cirrhosis and might require liver transplantation.

Primary Sclerosing Cholangitis

Primary Sclerosing Cholangitis (PSC) is essentially a disease of the bile ducts of the liver. However, ducts of the gallbladder and pancreas may also be affected.

Inflamed bile ducts may tend to become scarred and hardened, ultimately resulting in liver failure. Some of the major symptoms of the disease are fatigue, loss of appetite, weight loss and jaundice.

The diagnosis of PSC is done through Cholangiography. This procedure involves injecting a special kind of dye into the bile ducts and taking an X-ray.

“Around 70 percent of patients affected by PSC usually have ulcerative colitis, an underlying inflammatory bowel disease. PSC is more prevalent among men than women and generally begins between the ages of 30 and 60. However, the disease can also occur during childhood. Majority of children tend to exhibit non-specific symptoms such as fatigue, weight loss and itching.

As yet, an effective treatment for PSC has not been discovered. Most of the patients eventually suffer from cirrhosis and permanent liver damage.

The only known cure for PSC is liver transplantation. PSC should be regarded as a pre-malignant condition because it puts the patient in a highly vulnerable situation where he has greater chances of developing Cholangiocarcinoma. Cholangiocarcinoma refers to a malignant tumor of the bile duct. This condition occurs in about two out of 100,000 people.

Primary Biliary Cirrhosis

Primary Biliary Cirrhosis (PBC) is a chronic liver disease which mostly affects females than males. The disease often occurs between the ages of 30 and 60 years and is essentially characterized by progressive destruction of the bile ducts in the liver, eventually leading to scarring and cirrhosis.

Some of the prominent symptoms of the disease include itching, jaundice, deposits of cholesterol on the skin, retention of fluid and dry eyes or mouth. Asymptomatic patients generally tend to survive more than 10 years, while patients who have symptomatic PBC and jaundice often survive for about seven years. The disease is diagnosed on the basis of physical examination, biochemical tests and liver biopsy.

The presence of Antimitochondrial Antibody or AMA, the primary auto antibody marker is diagnostic of the disorder. AMAs are generally found in 96 percent of patients affected with PBC.

Identification of PBC is extremely vital in the diagnosis of the disease. This is because if effective treatment is done with ursodeoxycholic acid, it tends to reduce the progression of the disease and improves the chances of survival without the requirement for liver transplantation.

Cholelithiasis (Gallstones)

Gallstones are essentially classified into two main types; Cholesterol stones and Pigment stones. Cholesterol stones tend to occur exclusively in the gallbladder and comprise 50 percent to 100 percent cholesterol. Pigment stones originate in the biliary tree and are categorized as black or brown.

Some of the major symptoms include fever, jaundice and persistent pain. Ultrasonography is a simple and effective method of diagnosing the disease.

Approximately 80 percent of patients tend to remain asymptomatic and only about 20 percent of patients experience difficulty from gallbladder disease. An effective treatment for the disease is not yet discovered. However, attempts are being made to identify the genetic changes that are responsible for the formation of gallstones or the development of biliary cancer.