Fighting Biliary Diseases

A diverse spectrum of diseases can affect the liver and/or biliary tract. Dr. Arora’s fellowship training in Advanced Hepatology arms him with the expertise to help you fight biliary disease. Our team as a whole is skilled to educate you on diseases of the biliary tract and provide support throughout your diagnosis, treatment and disease management.

Biliary diseases affect the bile ducts and gallbladder, which are involved in the production and transport of bile. This liquid is produced by the liver and stored in the gallbladder, and aids in the digestion of fats and the transport of wastes. If any duct in this complex system becomes diseased or blocked, a number of benign but serious diseases may result, including gallstones, primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC).

Gallstones and Gallbladder Disease

Gallbladder disease is one of the most common of all digestive diseases. About one million Americans are diagnosed with gallbladder disease each year, and treatment generally requires surgery and hospitalization. Risk factors for the disease include heredity (gallstones tend to run in families), being overweight or rapid weight loss, pregnancy, cirrhosis and biliary tract infections.

A gallbladder attack may last a few days, and symptoms of gallbladder disease may include:

  • Intense, sudden pain in the upper right side of the abdomen
  • Indigestion or pain after meals that lasts a few hours
  • Intolerance of fatty foods
  • Pain upon taking deep breaths that moves to right shoulder blade
  • Nausea, chills, vomiting and a low fever
  • Jaundice (yellowing of the skin and eyes)
  • Abdominal bloating
  • Loose, light-colored stool
  • Rigid abdominal muscles on the right side

Our gastrointestinal team may perform a number of tests to determine if you have gallstones or gallbladder inflammation, including an endoscopic retrograde cholangiopancreatography (ERCP), blood tests and ultrasound.

Primary Biliary Cirrhosis

PBC is a chronic disease that causes the bile ducts in the liver to become inflamed, malfunction and slowly deteriorate. Primary biliary cirrhosis develops over time and may ultimately cause the liver to stop working completely. Most people are diagnosed early, with symptoms of fatigue and itchy, darkening skin, before the disease progresses. Early treatment delays — but does not stop — the eventual onset of cirrhosis and liver failure.

Our initial treatment for PBC is aimed at relieving your symptoms because there is no known cure. Vitamin replacement therapy, calcium supplements and drugs to treat itching may be prescribed. When a person has end-stage liver disease, a liver transplant is necessary.

Primary Sclerosing Cholangitis

PSC is similar to PBC in that it is a chronic disease that progresses slowly over time, with no known cure. Unlike primary biliary cirrhosis, primary sclerosing cholangitis damages the bile ducts both inside and outside the liver. In patients with PSC, the bile ducts become blocked due to inflammation and scarring. This causes bile to accumulate in the liver, where it gradually damages liver cells and causes cirrhosis, or scarring of the liver. The scar tissue may block drainage of the bile ducts leading to infection of the bile.

Unfortunately, many patients may have the disease for years before symptoms develop. When symptoms do occur, the most common are fatigue and itchy, darkening skin — similar to PBC — which are treated with medication and vitamin supplements. If liver failure becomes severe, a liver transplant may be necessary to prolong life.