MU Logo Department of Internal Medicine at MUMu Health Care

Bile Duct Disease:

What is bile duct disease?

The gallbladder stores bile until a person eats, then the gallbladder releases bile into the small intestine to help digest food.  Bile ducts are small drainage "pipes" that carry bile from the liver to the gallbladder and from the gallbladder to the small intestine. A variety of diseases can affect the bile ducts.  All block the bile ducts in some way, which is why the various diseases cause similar symptoms. 

Gallstones are the most common cause of blocked bile ducts.  Stones typically form inside the gallbladder and can block the common bile duct, a large drainpipe at the base of the liver.  If the duct remains blocked, waste can collect in the bile duct system and in the bloodstream.  If a gallstone stops in between the gallbladder and the common bile duct, an infection may occur. 

Symptoms of bile duct disease:

Symptoms of a blocked bile duct may be abrupt and severe (for example, when a gallstone blocks the whole drainage system all at once), or they may appear slowly many years after bile duct inflammation started. Bile duct diseases cause some symptoms when waste products build up in the body. Other symptoms result from the bile ducts' failure to deliver certain digestive juices (bile salts) to the intestines, preventing the absorption of some fats and vitamins. Symptoms of a blocked bile duct include:

Diagnosis: 

If a physician suspects that a person has a bile duct problem based on symptoms or if a blood test shows that the person has a high level of bilirubin, the physician may take the patient’s medical history and perform an exam to look for clues that could explain damage to the bile ducts and liver.  Because liver inflammation (hepatitis) and liver scarring (cirrhosis) can cause similar symptoms, a doctor will ask about the patient’s alcohol use, drug use and sexual practices, all of which can result in liver disease.  Because some medicines can slow drainage through the bile ducts, the patient’s medicines should be reviewed by the physician. 

Common diagnostic tests include:

Treatment & Prevention options:

To treat a gallstone blockage accompanied by signs of persistent pain or infection, a gastroenterologist can remove stones in the bile duct using endoscopic retrograde cholangiopancreatography (ERCP).  The endoscope cuts through the base of the common bile duct, allowing a stone to pass through.  In some cases the endoscope may be used to remove the stone using wire loops.  Physicians recommend that anyone with a bile duct blockage from a gallstone have his or her gallbladder removed to prevent another blockage.

Another method requires rerouting the bile drainage and additional intestinal surgery.  However, most persons with this condition continue to have inflammation due to poor drainage, and eventually develop cirrhosis and require a liver transplant.

If greasy stools are a problem, a low-fat diet may be helpful.  Doctors recommend multivitamin supplements to improve nutrition.

If a person has gallstones, he or she can prevent bile duct blockage and serious infection by having his or her gallbladder removed. This is done using small incisions in the abdomen, in a surgery called laparoscopic cholecystectomy. 

If the individual is overweight or has high cholesterol, he or she may be at higher risk of developing gallstones.  To avoid trouble, a physician may recommend controlling diet and exercise.  Women who take birth control pills or hormone replacement therapy are at higher risk of gallstones and may factor this risk in their decision to use these medications.

Related information:

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Last Revised: 09/21/2006