After you eat, the gallbladder releases bile to help in digestion and fat absorption. Bile also helps clear the liver of waste products. Obstruction of any of these bile ducts is referred to as a biliary obstruction.
Many of the conditions related to biliary obstructions can be treated successfully. However, if the blockage remains untreated for a long time, it can lead to life-threatening diseases of the liver.
You have several types of bile ducts. The two types of bile ducts in the liver are intrahepatic and extrahepatic ducts. The biliary duct, or the duct from the gallbladder, also opens into the common hepatic duct. The bile duct from this point onward is known as the common bile duct or choledochus. Before emptying into the small intestine, the common bile duct passes through the pancreas. The risk factors for biliary obstruction usually depend on the cause of the obstruction.
The majority of the cases are a result of gallstones. This makes women more vulnerable to developing a biliary obstruction.
Other risk factors include:. The symptoms of biliary obstruction can depend on the cause of the obstruction. People with biliary obstruction usually have:. Various tests are available for people who may have a biliary obstruction. Based on the cause of the obstruction, your doctor may recommend one or more of the following tests. A blood test includes a complete blood count CBC and liver function test.
Blood tests can usually rule out certain conditions, such as:. Ultrasonography is usually the first test performed on anyone suspected of a biliary obstruction. It allows your doctor to see the gallstones easily. A hepatobiliary iminodiacetic acid scan, or HIDA scan , is also referred to as a biliary radionuclide scan.
It uses radioactive material to provide valuable information about the gallbladder and any possible obstructions. The enzyme and bicarbonate secretions together are called the "exocrine" function of the pancreas. The bile ducts function as a drainage system for the liver.
Bile is a bitter dark fluid, composed of bile acids, bile pigments, bilirubin, cholesterol and other fats, water and electrolytes. Some of these constituents are useful for digestion, others are simply waste products i. The gallbladder acts to store bile, and make it more concentrated by removing water. Although thin, the gallbladder wall has muscle tissue, so that it can contract and empty when necessary. Production of the bile and pancreas juices and their release into the duodenum through the papilla of Vater are controlled by abdominal nerves and also specific messengers hormones which pass to their targets through the bloodstream.
These systems also control contractions of the gallbladder, and relaxation of the sphincter of Oddi the muscular valve within the papilla of Vater. Together these insure that the juices are produced and released into the duodenum only when they are needed, that is when food arrives from the stomach ready for final digestion, and subsequent absorption. The pancreas also has an "endocrine" function — the production of insulin and other important hormones. These are produced in separate tissues within the pancreas islets of Langerhans , and passed directly into the blood stream rather than into the pancreatic duct.
Insulin is very important for control of sugar levels in the blood; lack of insulin results in diabetes. The pancreas produces many other enzymes such as somatostatin, pancreatic polypeptide, glucagon, etc. Pancreatic juices may not reach the duodenum if the duct or papilla is blocked, or if the pancreas is so damaged by disease that it cannot produce adequate bicarbonate and enzymes. Lack of pancreatic juices results in inadequate digestion.
Clinically this is noteworthy by the passage of large bowel movements, which a strong odor and are difficult to flush down the toilet because of their high content of fat. Indeed, sometimes patients with pancreatic insufficiency may note an "oil slick" on the toilet water. Excessive fat in the stools is called "steatorrhea. These pancreatic enzymes can be replaced, at least to a certain extent, by giving them in the form of a medicine by mouth — so called pancreatic enzyme supplements.
It is not usually necessary to replace the missing bicarbonate output. Lack of bile also interferes with digestion particularly of fats and can also result in steatorrhea.
Lack of bile in the duodenum is usually due to blockage of the main bile duct, or papilla. The liver continues to produce bile, which then spills backwards into the blood stream.
Eventually this causes yellow discoloration of the body jaundice , first noticeable in the whites of the eyes. If bile does not enter the duodenum, bowel movements lose their usual color, and look like pale putty. When the bile ducts are blocked, retention of bile salts in the blood can result also in considerable itching pruritus. Blockage of the bile ducts or pancreatic ducts can cause pain due to overdistention.
Lack of insulin secretion by the pancreas results in diabetes. It is also possible to have too much insulin when the islets of Langerhans overact, or become tumorous. This results in the blood sugar falling below normal levels, resulting in faintness and eventually coma.
Lack or excess of other pancreatic hormones such as somatostatin, vasoinhibitory peptide, glucagon, etc. Digestive Disease Center. Digestive Diseases. Small Intestine. The undigested fat can also cause stools to be unusually pale. They might also be bulky, greasy, and float in the toilet. Early bile duct cancers seldom cause pain, but bigger tumors may cause belly pain, especially below the ribs on the right side. These are not common symptoms of bile duct cancer, but they may occur in people who develop an infection cholangitis as a result of bile duct blockage.
These symptoms are often seen along with a fever. Keep in mind: Bile duct cancer is rare. These symptoms are far more likely to be caused by something other than bile duct cancer. For example, people with gallstones have many of these same symptoms. And there are many far more common causes of belly pain than bile duct cancer.
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