Re: Cholangitis Attacks

April 10, 2006

,

Cholangitis is an infection of the bile ducts, characterized by fever,

RUQ (right upper quadrant) pain and jaundice. Because free flowing

bile rarely supports bacterial infection, some bile duct blockage is

usually the initiating factor. Since the onset of cholangitis may be

sudden and may be relieved suddenly when the blockage is broken, the

episodes are often called " attacks " . However, just because the fever

has subsided the bacteria are probably not cleared from the bile duct

system. Behind each little stricture there is probably a pool

of " stagnant " bile harboring bacteria just waiting for the next chance

to flourish during the next blockage.

Since you did not mention fever as one of your symptoms, there is the

possibility that you had a blockage without infection - a

gallstone " attack " . If you have strictures in your bile ducts then

even a very small stone, which would pass without problems in most

people, could cause a blockage when it could not pass through the

narrowed duct, causing a steady pain in the upper abdomen that lasts

for 30 minutes to several hours, and may radiate around to your back

and shoulder.

The typical treatment for a gallstone attack is what you do, wait for

it to pass, although in some cases an ERCP will be used to relieve the

blockage by removing the stone and/or expanding the stricture. If the

attacks are frequent and severe, surgical removal of the gall bladder

is usually recommended.

If you do have fever in conjunction with the attacks you need

treatment for the infection. Untreated the fevers can escalate into

full blown sepsis, a life threatening situation.

Best regards,

Tim R

> ... it starts out as a lower

> back ache and then penetrates to my chest and I am very

uncomfortable

> for anywhere from a few hours to all day. It feels like a lot of

> pressure is being forced upon me and I can't make it go away.

>

> ... explain what a Cholangitis attack is.

>

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