Bile Duct Stones: Symptoms, Causes & Treatment

Bile Duct Stones

By Dr. Lee Ser Yee

Bile duct stones are usually gallstones that have moved into the bile duct. These stones can sometimes get stuck in the bile duct, in which case, medical intervention becomes necessary to prevent complications from arising.

What are bile duct stones?

Bile is a golden-yellow fluid produced by the liver which helps in the digestion of fats in our diet (it is also why our stools are brown-yellowish). Bile travels through tiny tubes called Bile ducts from the liver to the small intestine (duodenum). Some of the bile produced is stored in the gallbladder.

Sometimes, stones which form in the gallbladder (gallstones) may drop into the bile duct, causing blockage and resulting in jaundice (yellowing discolouration of the eyes and tea-coloured urine and pale stools).

How do bile duct stones develop?

Most of the bile duct stones originate from the gallbladder as gallstones when there is an imbalance of the bile and it becomes too concentrated in the gallbladder. However, bile duct stones can develop anywhere in the biliary tract where there is bile - within the liver, gallbladder and common bile duct.

Most gallstones do not cause symptoms, but they can be squeezed out of the gallbladder into the bile ducts(choledocholithiasis) and cause problems if they block the bile duct or the pancreas.

Risk Factors

Generally similar to risk factors for gallstones, any disease that results in a slow flow of bile or imbalance of the bile constituents

Age of 40 years or older
Females
Pregnancy
Family history of gallstones or bile duct stones
Obesity / Overweight
High-fat diet / Sedentary lifestyle
Diabetes mellitus
Drugs- Cholesterol -lowering medications, birth control pills
Congenital or acquired abnormalities of bile ducts
Bacterial or parasitic infections of the bile duct- e.g., Recurrent pyogenic cholangitis (RPC)
Others - Certain blood disorders - e.g., Hemolytic anemias, liver cirrhosis, prolonged intravenous feeding

Symptoms of bile duct stones

Bile duct stones can cause pain in the upper abdomen, which is felt most often after a meal. If the stone causes blockage of the bile duct, it can also cause the following symptoms:

Jaundice - Yellowing of the skin and eyes, pale stools, tea-coloured urine
Fever, Chills or Rigors
Loss of appetite and weight
Nausea and vomiting
Severe, persistent abdominal pain

Diagnosis

When bile duct stones are suspected, after a comprehensive review and examination, the doctor may order some blood tests and imaging tests to visualise the gallbladder and bile duct. These include liver function tests, an ultrasound, computerised tomography (CT) scan, and/or magnetic resonance imaging (MRI/MRCP).

Bile duct stones can potentially result in serious problems if the obstruction is acute and/or prolonged resulting in severe infection (Cholangitis or Sepsis), inflammation (acute pancreatitis) or liver dysfunction or failure.

Do consult a specialist early for an assessment and treatment should you be experiencing any discomfort in your abdomen or any of the symptoms listed above.

“Bile duct stones are a common cause of obstructive jaundice in young to middle-aged adults. With minimally invasive techniques, these stones can be well treated with minimal risks and pain.”