Enlarged bile duct: Causes, symptoms, and treatment

Bile ducts have a major function when it comes to our well-being. Having an enlarged bile duct can lead to uncomfortable pain as well as a host of other symptoms.

Bile is a liquid produced by our liver. It is a yellowish-brownish or dark-green substance that the bile duct normally carries from the liver and gallbladder through the pancreas to the duodenum, which is part of the small intestine. Bile essentially helps digest fats from the food we eat. If a blockage or obstruction occurs in the bile duct, it enlarges.

What causes enlarged bile ducts?

Gallstones are one cause of bile duct enlargement. In fact, gallstones are a build-up of bile, which forms small stone-like clumps that can lead to blockages if they get large. This is one of the most common causes of bile enlargement. However, there are other reasons for a person to have the problem.

Here’s a look at some of the other causes of enlarged bile ducts:

• Inflammation. Inflammation of the bile duct can occur due to infection, which then leads to enlargement.
• Porta hepatis. An enlargement of the lymph node on the surface of the liver where the vein and artery enter and hepatic duct leaves.
• Cysts. Can be common in the bile duct and cause enlargement.
• Surgery. Postoperative stricture (narrowing) in the region of the bile duct.
• Cancer. Malignant cancer of the bile duct is called cholangiocarcinoma and grows slowly. It eventually spreads throughout the liver. A tumor at the head of the pancreas can also lead to enlargement of the bile duct.

When doctors take a close look at what causes enlarged bile ducts, they often discover that diet plays a big role. For example, gallstones are commonly linked to a high cholesterol diet.

If you have an enlarged bile duct, it is important to get treatment, otherwise, it may lead to complications.

Enlarged bile duct symptoms

Of course, symptoms of enlarged bile ducts depend on the root cause. In the case of gallstones, pain in the upper abdomen can be really severe. It is the type of pain that can be difficult to relieve. Below is a rundown of some of the other enlarged bile duct symptoms associated with gallstones.

• A long history of flatulent dyspepsia (regurgitation or reflux)
• Episodes of abdominal colic
• Pancreatitis
• Jaundice
• Dark urine, pale feces
• Nausea and vomiting

When it comes to strictures, about 15 percent of bile duct problems are found during the time of surgery, but 85 percent are discovered following the operation. Discharge of bile is usually detected through the drainage tube along with deepening jaundice.

In the case of enlarged bile duct due to cancer, the following symptoms can occur:

• Gallstones (50 percent of cases)
• Mild pain
• Jaundice
• Weight loss
• Decreased appetite
• Mild fever
• Itching all over body
• Dark yellow or orange urine
• Pale or white colored bowel movements

Enlarged bile duct treatment

For some people, gallstones don’t require treatment because they simply pass on their own. There are also cases where the gallstones do not present any symptoms and can be addressed in a natural way so that they don’t get worse and start to cause unbearable symptoms.

Here’s a list of lifestyle tips for people who have gallstones with no symptoms:

• Maintain a healthy weight
• Avoid rapid weight loss
• Eat an anti-inflammatory diet
• Exercise regularly
• Take supplements that are doctor approved

If someone who has gallstones is in a lot of pain, the doctor will likely recommend surgery. Today, patients are fortunate that there is laparoscopic gallbladder removal, which is less invasive than previous surgical techniques. With the laparoscopic procedure, a patient can usually go home on the same day or the day after as long as there are no complications. Some people do experience a loose or watery stool right after gallbladder removal, which can be treated with a low-fat diet so that less bile is released.
If the enlarged bile duct is due to cancer, there could be a combination treatment plan. The treatment options depend on the stage of cancer, the patient’s overall health status, and the patient’s personal preferences. Surgery to remove the tumor and/or surrounding tissue is one possibility. There are doctors who specialize in treating the liver and bile ducts as well. They are called hepatobiliary surgeons. Let’s take a look at all the options for cancer:

• Surgical removal of the bile duct—The surgeon removes the entire organ. The operation could also include removal of lymph nodes to check for cancer.
• Partial hepatectomy—When cancer is near the liver, the surgeon may remove a part of it. The remaining part of the liver takes over the functions.
• Whipple procedure—This is an extensive operation that takes place if the cancer is near the pancreas. It involves removing all or part of the pancreas and part of the small intestine, bile duct, and stomach. Between 5–10 percent of people do not survive this operation.
• Liver transplant—The liver is completely removed along with the bile ducts. A donor liver is transplanted. This procedure is rarely used since bile cancer has a high risk of recurring.
• Radiation—A therapy that uses high-energy x-ray or other particles to destroy cancer cells. This consists of a specific number of treatments over a set period of time.
• Chemotherapy—This is the use of drugs to destroy cancer cells. Chemo is meant to stop cancer cells’ ability to grow and divide. Sadly, bile duct cancers are resistant to many types of chemotherapy, so clinical trials are the best way to try this type of treatment.

Patients with bile duct strictures may be able to have endoscopic therapy, which can be done on an inpatient or outpatient basis. Those who require surgery will have to stay in the hospital longer. For the most part, medical treatment for strictures is all about managing any potential complications. Those who have infections of the bile duct respond well to antibiotics.

If you are generally a healthy person who follows a nutritious, balanced diet and participates in regular exercise, you are lowering your chances of having an enlarged bile duct. If you have a history of gallstones, experience an abdominal injury, have an infection that leads to a blockage, have a weakened immune system, or have had recent biliary surgery, then you are at higher risk of bile duct enlargement.

When you or someone you know experiences the symptoms we described earlier, it is crucial to seek medical attention to determine whether or not you have an enlarged bile duct. Some of the complications, as a result of not getting treated for an enlarged bile duct, can be life threatening.

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