Cholangitis (Inflammation of the Bile Duct) – Causes, Symptoms & Treatment

Cholangitis (inflammation of the bile ducts)

Cholangitis , or bile duct inflammation , is an infection of the bile duct . Those affected typically suffer from fever, upper abdominal pain and jaundice. Treatment is usually through the administration of antibiotics.

What is cholangitis?

Cholangitis is inflammation of the bile ducts. These canal-like structures are needed to transport bile from the liver through the gallbladder to the duodenum . Among other things, toxins are transported away in the bile. Their main task, however, is the digestion of fat.

Characteristically, those affected suffer from severe pain in the upper abdomen, fever and jaundice, i.e. a yellow discoloration of the skin. Cholangitis is often accompanied by vomiting and discolored stools.

A basic distinction is made between acute, purulent cholangitis, non-purulent cholangitis and sclerosing cholangitis. The different forms of cholangitis have different causes, but mostly lead to the same symptoms.


Acute cholangitis is largely caused by bacteria . In many cases, the pathogenic bacteria originate from the small intestine , from which they enter the bile duct in an unexplained manner. In exceptional cases, viruses are responsible for the inflammatory reaction in the bile ducts.

The most common cause of bile duct inflammation is the formation of gallstones . From a certain size, these clog the bile ducts and thus prevent the transport of bile. Pathogens can then easily settle in the accumulated bile and trigger an infection of the bile ducts. To date, it is not known what causes chronic cholangitis.

It is sometimes assumed that it is an autoimmune disease, in which the immune system recognizes its own cells as foreign bodies and damages them. Rare causes of bile duct inflammation include tumors in the bile ducts, parasitic infections, and diverticula . After operations on the liver, the duodenum or the bile ducts themselves, narrowing can sometimes occur, which facilitates the development of bile duct inflammation. Genetic malformations of the bile ducts are very rarely the trigger for cholangitis.

Symptoms, Ailments & Signs

Diagnosis & History

In order to diagnose acute cholangitis, the medical history is usually sufficient. During the consultation with the patient, the doctor treating you determines, among other things, how long the symptoms have existed and whether there are any risk factors such as being overweight or having a gall bladder problem.

This is followed by the physical examination. If there is actually an inflammation of the bile ducts, the doctor can determine the so-called Charcot triad. This is a complex of three symptoms, namely fever, right upper abdominal pain and jaundice. If these three symptoms occur together, the likelihood of cholangitis is very high.

A blood test is usually performed to confirm the suspected diagnosis . In the case of bile duct inflammation, the number of leukocytes is usually increased, which indicates an infection. Gallstones are diagnosed with an ultrasound scan. Antibodies in the blood often diagnose sclerosing cholangitis .

The course of a bile duct infection depends on the severity of the disease. If an acute inflammation of the bile ducts is diagnosed and treated quickly, a complete cure can be expected.


In most cases, complications only arise when the bile duct infection is diagnosed too late or when treatment is started too late. The patient mainly suffers from pain in the upper abdomen and a general feeling of illness. The eyes and skin turn yellow and the affected person is no longer able to carry out physical activities.

It can also lead to a very high fever. If the bile duct inflammation remains untreated, it can also lead to blood poisoning, which in the worst case can lead to the death of the patient. In many cases, there is also severe itching on the skin due to the inflammation of the bile ducts. Treatment is usually with antibiotics and painkillers.

If this starts early, the patient will have no further complications and the disease will subside after just a few days. If the bile duct inflammation has caused gallstones to form, these must also be removed. Life expectancy is not reduced if the bile duct infection is treated successfully. However, it cannot be ruled out that the disease will recur in the course of life.

When should you go to the doctor?

Acute cholangitis requires a timely visit to the doctor. This is quickly realized by those affected by the severe symptoms, since the sometimes severe pain is difficult to bear without medical treatment.

The other signs of inflammation of the bile ducts also make a doctor’s visit necessary, since neither jaundice nor fever or chills are compatible with the ability to work and significantly reduce the quality of life of those affected. There are two other reasons for a quick visit to the doctor: On the one hand, choalangitis with all its unpleasant symptoms almost never resolves spontaneously without treatment. On the other hand, a visit to the doctor can protect against serious complications such as shock or massive effects on the patient’s central nervous system or kidneys.

Due to the fact that cholangitis is often associated with severe courses, visiting a doctor or a hospital is justified even if there is a mere suspicion of this disease. Because the earlier the treatment begins, the faster and more pleasant the medical help is often. That’s why it makes sense to see a doctor for patients with chronic bile problems or a concomitant disease, for example in the intestinal area. The first treatment for cholangitis does not have to be done by the doctor treating you, but can be done in any emergency room.

Treatment & Therapy

In order to prevent serious complications such as sepsis , cholangitis must be treated by a doctor as soon as possible. Since acute inflammation of the bile ducts is usually caused by bacteria, antibiotics are used to treat it . Which antibiotic is prescribed by the doctor depends on the type of bacteria. Cephalosporin is often used.

Effective treatment of the infection is usually only possible if those affected take two different antibiotics at the same time. In the majority of cases, the patient’s health improves within a few days of antibiotic administration. Since inflammation of the bile ducts is often very painful, painkillers can be used in addition to antibiotics. Particularly suitable are agents that also have an antispasmodic effect, since many sufferers suffer from colicky pain. If the fever is very high, antipyretic drugs must be taken to maintain bodily functions.

If gallstones are the cause of the infection, they usually have to be removed. In many cases, the inflammation of the bile duct then goes away on its own. If there is a general disturbance in the flow of bile, a stent can be used to support the bile duct. The goal of therapy is to restore bile flow. In the case of sclerosing cholangitis, this is hardly possible since the causes are unknown and therefore cannot be treated. In these cases, the treatment consists of a purely symptomatic therapy, which increases the general well-being.

Outlook & Forecast

Cholangitis has a favorable prognosis in adults with a stable immune system and no other diseases. Healing and long-term freedom from symptoms are linked to early treatment and therapy of the symptoms. With the use of medication, recovery from cholangitis is achieved within a few weeks in most cases. A recurrence of the disease is possible in principle, but is only rarely observed.

A prerequisite for healing the bile duct infection is the removal of any gallstones that may be present. These prevent the patient from recovering until they completely disappear. Without medical care, the patient’s health can deteriorate significantly. There is also a risk that the inflammation will change from a recurrent to a chronic course.

The longer the cholangitis remains untreated, the higher the risk of complications. This often leads to changes in the bile ducts. Scarring and narrowing of the bile ducts can be expected in these patients. These complications worsen the prognosis and can lead to further diseases. In severe cases, there is a risk of bile backlog, liver cirrhosis and the development of bile duct cancer . This increases the patient’s risk of shortening normal life expectancy. The healing process is generally delayed in patients with a weakened immune system.


It is not possible to specifically prevent cholangitis. Nevertheless, there are various measures that significantly reduce the risk of developing acute bile duct inflammation. Because gallstones are the most common cause of bile duct infection, they should be prevented. The best preventive measure is a healthy diet. A low-fat diet that is high in fiber is best. In addition, it is important to drink enough liquid. The chronic form of cholangitis cannot be prevented.


In most cases, those affected with a bile duct infection only have a few follow-up measures available. In the case of this disease, the person affected must primarily consult a doctor so that the symptoms do not worsen further or other complications occur. The earlier a doctor is consulted, the better the further course, so that the person concerned should contact a doctor at the first signs and symptoms of bile duct inflammation.

Self-healing cannot occur in this case. The disease itself is usually treated by taking antibiotics. It is always important to ensure that the dosage is correct and that it is taken regularly so that the symptoms are alleviated. It should also be noted that the antibiotics should not be taken together with alcohol, otherwise their effect will be weakened.

In children, parents must monitor and control the intake. Even after the treatment, further regular examinations by a doctor are very important in order to detect damage to the internal organs at an early stage. As a rule, the patient’s life expectancy is not reduced if the bile duct inflammation is recognized and treated in good time.

You can do that yourself

Inflammation of the bile duct makes those affected feel very ill. Treatment should be quick to minimize the risk of consequential damage. If left untreated or self-treated, a life-threatening condition can occur. Strict bed rest is usually observed on its own.

Depending on the cause of the disease, it is advisable to combine antibiotic therapy with probiotic treatment of the intestine. In the acute stage, food should be avoided entirely in order to relieve the bile ducts. Later, the diet should be changed to light food – also to relieve the usually involved liver.

Sufficient fluid intake is also beneficial for the recovery process. Still mineral water and unsweetened herbal teas should be preferred. Even after a successful treatment, the liver is usually under a lot of stress, so alcohol and fats should be avoided in the subsequent period.

If an autoimmune disease is the cause of the inflammation, it is important to constantly strengthen the immune system by avoiding stress , ensuring balancing relaxation , a balanced diet and regular exercise. Micronutrient therapy ( selenium , minerals) has also proven to be beneficial in inflammatory processes.

Homeopathically prepared Colocynth (C6), Magnesium phosphoricum (C6), Bryonia album (C6) or Chamomilla vulgaris (C6) taken every hour can help against the pain in the acute stage of the disease.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.