Your gallbladder is a small pear-shaped organ that sits below your liver. It stores bile, a liquid that helps your body digest fat. The bile comes from the liver through the bile ducts. 

Bile duct disease refers to several conditions that affect these tubes. They can become inflamed, infected, blocked, or narrowed. 

When blocked, the bile backs up into the liver, causing pain and other symptoms. Gallstones are the most common cause of bile duct blockage. They form from too much cholesterol that turns into “stones,” or hard bits in the bile. 

Signs of bile duct diseases include:

• Pain on your right side, often felt in the upper back
• Jaundice
• Nausea
• Fever
• Itching
• Unexplained weight loss
• Diarrhea

Types of bile duct disease

There are several types of bile duct disease. They can all cause blockages in your bile ducts and, eventually, problems with your liver.

• Gallstones: Stones or sludge form in the gallbladder. When you’re having a bile duct blockage or “gallstone attack,” you may feel pain in your upper right abdomen, often in the back, under the shoulder blade. It may come on after eating and come and go in waves.
• Primary biliary cholangitis (PBC): Inflammation from an overactive immune system that can damage the small bile ducts in the liver. Without ducts, the bile collects and damages the liver, eventually causing liver failure.
• Inflammation of the bile duct: Causes of inflammation include bacterial infection or blockages. It can be chronic (long-term) and cause liver damage. It can also be acute (short-term), a medical emergency if bacteria enter your bloodstream.
• Bile duct cancer: A rare form of cancer. The cancer may start in the bile ducts inside the liver, where the ducts leave the liver or in the bile ducts outside the liver.

Your treatment will depend on your bile duct issue, age, overall health, and where the blockage is. 

Prevention

To prevent gallstones, a healthy lifestyle is key. To minimize your risk of getting bile duct disease, you should:

• Eat a healthy diet
• Exercise regularly
• Maintain a healthy weight
• Avoid alcohol and nicotine

Medicine

You can take over-the-counter pain medicine for a gallbladder attack. Your doctor may prescribe antibiotics if you have a bacterial infection. Other medicines can help improve liver function and relieve itching.

Medicines used to treat bile duct cancer include radiation, chemotherapy, immunotherapy, and targeted therapy.

Procedures

Your doctor may be able to remove gallstones or break them up with shock waves, so they pass through the bile ducts. They perform this procedure using an endoscope, a thin tube with a camera.

We may be able to use a minimally invasive surgery to drain bile from the liver. Or we may insert stents—tubes—into the bile ducts to keep them open.

But it may be necessary to remove your gallbladder. This common surgery is also called cholecystectomy.

Liver transplant

If your bile duct disease results in serious liver damage, a liver transplant may be an option for treatment. If you're a candidate for a transplant, we can complete your initial evaluation and work with the transplant center of your choice. We also provide expert care after your transplant.