Stones in the bile duct: causes, symptoms and treatment

Choledocholithiasis is a term for the presence of stones in the bile ducts. As a rule, such obstructions are formed in the gallbladder. The ducts are small tubes through which bile flows from the gallbladder into the intestine. The organ is a pear-shaped formation located under the liver, in the upper right corner of the abdominal cavity. As a rule, the stones remain in the bladder or freely pass through the common bile duct.

Nevertheless, according to the results of statistical studies, it was found that about 15% of patients with gallstones have stones in the bile ducts.

Symptoms

Choledocholithiasis is a sluggish disease that can not express itself for months or even years. However, in cases where the stone is stuck in the duct and turns into obstruction, the following signs of disturbance occur:

• Pain in the abdominal cavity localized at the top in the right side or in the middle;
• Increased body temperature;
• Jaundice (yellowing of the skin and eyes);
• loss of appetite;
• nausea and vomiting;
• Stool clay color.

A stone in the duct of the gallbladder can cause both irregular and constant pain sensations. From time to time the pain seems to calm down, so that after a certain period, the pain intensifies sharply. Acute pain syndrome can lead to the need for urgent medical treatment. The most severe manifestations of the disorder are often confused with signs of cardiac pathology - for example, a heart attack.

Complications

The stone in the bile duct (the symptoms of which the patient is long ignored) can lead to infection of the bile ducts. Bacteria that rapidly multiply in the area of the lesion can move inside the liver. The consequences of such infection pose a direct threat to human life. In addition to bacterial damage, complications such as cholangiolytic liver cirrhosis or pancreatitis can also occur.

Causes

Two types of stones are known: cholesterol and pigment.

Cholesterol formations have a yellowish color and are the most common. Scientists believe that stones of this type are gradually built up of bile, which contains:

• Too much cholesterol;
• Excess bilirubin;
• Not enough salts of bile acids.

Cholesterol deposits occur in the case of incomplete or too rare emptying of the gallbladder.

Until now, it is not known exactly why pigment stones in the bile ducts are formed. According to the doctors, they are found in patients suffering from:

• Cirrhosis of the liver;
• Infectious diseases of the biliary tract;
• Hereditary blood diseases, leading to excessive production of bilirubin by the liver.

Risk factors

The risk group is primarily attributed to people with a history of cholelithiasis and other pathologies associated with the functioning of the bile producing organ and associated pathways. Moreover, in such patients, stones in the bile ducts are often found after removal of the bladder. Gallstones are sometimes enough to cause significant discomfort and severe pain syndrome.

The following factors increase the risk of deposition of cholesterol and pigmented formations in the excretory pathways:

• obesity;
• A high-calorie diet with an excessive fat content and a low level of fiber saturation;
• pregnancy;
• Long post;
• Rapid weight loss;
• Lack of physical activity.

Some of these factors are fairly simple to correct, making appropriate changes in their lifestyle.

Circumstances that can not be changed include:

• Age: stones are more often found in older people;
• Sex: women suffer from this disease more often;
• Nationality: among Asians, Mexicans and American Indians, choledocholithiasis is diagnosed more often than among representatives of other peoples;
• Family history: according to some scientists, genetic features can play a significant role in the development of predisposition to choledocholithiasis.

Diagnostics

If there is a corresponding symptomatology, the doctor will have to make sure of the presence of stones in the common bile duct. For diagnostic purposes, one of the following imaging studies is performed:

• Transabdominal ultrasound - a procedure in which high-frequency sound waves are used to study the liver, gallbladder, spleen, kidney and pancreas;
• Computed tomography of the abdominal cavity (cross x-ray);
• Endoscopic ultrasound (the ultrasound probe is placed in a flexible endoscopic tube and is guided through the oral cavity into the digestive tract);
• Endoscopic retrograde cholangiography is a procedure that allows to localize not only stones in the bile ducts, but also other pathological phenomena (tumors, sites of constriction);
• Magnetic resonance cholangiopancreatography - MRI of the gallbladder and duct of the pancreas;
• Percutaneous transhepatic cholangiogram - radiography of bile ducts.

The doctor can also prescribe one or more blood tests to make sure that there is or is not an infectious infection and at the same time to check the stability of the liver and pancreas. Most often, the following examinations are scheduled:

• general blood analysis;
• Test for bilirubin;
• Analysis of pancreatic enzymes;
• Analysis of liver function.

Treatment

Stones from the bile duct should be removed to ensure normal patency and the disappearance of pain. In order to eliminate obstruction, doctors can recommend one of the following procedures:

• Extraction of stones;
• Breakdown of cholesterol and pigmented formations into fragments (lithotripsy, crushing);
• Surgical operation for the removal of the gallbladder and duct obstruction (cholecystectomy);
• A surgical operation consisting in dissection of the common bile duct to remove stones or facilitate their passage (sphincterotomy);
• Biliary stenting.

Procedures

Endoscopic biliary sphincterotomy remains the most common treatment for choledocholithiasis. During this procedure, a special device in the form of a balloon or a basket is placed in the clogged bile duct. With its help eliminate the obstruction of the path. This method is proven to be effective in 85% of cases.

If the stone does not come out on its own and the doctor suspects that an endoscopic biliary sfinkterotomy will not be enough, lithotripsy is prescribed. In this procedure stones are crushed into small fragments to facilitate their extraction or self-passage.

A stone in the duct of the gallbladder can coexist with a similar formation in the organ itself. In such cases, the most effective treatment is considered to remove the gallbladder. During the surgical operation, the doctor will examine the duct to make sure that it is normally passable.

If the stones can not be completely removed by surgery for any reason (and if you have long suffered from pain caused by stones in the obstructed duct, but do not want to remove the gallbladder), the doctor will recommend biliary stenting. The procedure consists in the installation of tiny tubes that extend the passage and thereby eliminate obstruction and stones in the bile duct. The operation is sparing and provides effective prevention of choledocholithiasis cases in the future. In addition, stents can protect against infectious diseases.

Prevention

If once you have already experienced pain associated with choledocholithiasis, most likely, the pain syndrome will repeat - and more than once. Even removal of the gallbladder is not the best treatment: stones from the bile duct should be eliminated purposefully, otherwise there will remain a risk of manifestation of typical symptoms of the pathological condition.

Nevertheless, in many cases it is possible to prevent choledocholithiasis. To do this, it is enough to introduce small changes in your lifestyle. The risk of the disease significantly reduces moderate exercise and light changes in diet. Doctors advise as often as possible to make walks and make sure that in your diet in large quantities there is vegetable fiber. Consumption of saturated fats is desirable to reduce.

Long-term forecast

In 2008, several well-known medical clinics in Canada and the United States conducted a study in which approximately 14% of patients felt the symptoms of the presence of stones in the bile ducts again for fifteen years after the first manifestation of the typical pain syndrome and the appropriate treatment. Obviously, the removal of stones from the bile ducts is not always done with sufficient care, as there is reason to believe that a recurrent disease is associated with an increase in residual cholesterol formations in size.

Folk remedies

Alternative medicine is not considered to be a highly effective remedy for choledocholithiasis, however, according to some experts, simple folk remedies prepared at home can increase the current of bile or prevent excessive production and accumulation of cholesterol.

Do you feel pain and suspect that its cause is a stone in the bile duct? What if I do not have a chance to see a doctor? Try one of the following folk methods.

Natural preparations

• Pour a tablespoon of apple cider vinegar into a glass of apple juice and mix. Drink every time you feel pain in the area of the gallbladder and ducts. The drug has an anesthetic effect after 5-15 minutes.
• Add four tablespoons of lemon juice to a glass of water. Drink the mixture on an empty stomach every morning. The therapy lasts several weeks - until the stones are completely eliminated from the body.
• Boil a glass of water, add a teaspoon of chopped dried peppermint leaves, remove from heat, cover and insist for five minutes. Strain and add a teaspoon of honey. Drink mint tea warm, twice a day for 4-6 weeks, preferably between meals.
• Prepare the vegetable mixture. To do this, squeeze the juice from a single beet, one cucumber and four medium-sized carrots. Mix and drink twice a day. Follow these instructions for two weeks and you will notice how quickly your condition comes back to normal.

Medicinal herbs

• Place a teaspoon of powder from the dried root of the dandelion into a glass. Fill with hot water, cover and leave for five minutes. Strain, add a little honey to improve the taste. Drink such tea from a dandelion two or three times a day for 1-2 weeks to dissolve the stones in the ducts after removal of the gallbladder.
• Healing tea can also be made from other useful plants. Add two teaspoons of althea root medicinal and one teaspoon of mahogany mahogany in four glasses of water. Boil the mixture for 15 minutes, then remove from heat. Add two teaspoons of dry dandelion leaves and one teaspoon of dried peppermint leaves, then press tea for 15 minutes. Strain and drink during the day.

In addition, tender green dandelion leaves can be eaten directly in food - for example, steamed or added fresh in vegetable salads.

Dandelion is contraindicated in patients with diagnosed diabetes.