Cholangitis is a disease that affects the bile ducts and the liver. This disease, often asymptomatic, is difficult to diagnose. Treatment is by injection of a bile acid substitute. 

Chaolangitis is inflammation of the bile ducts, which tend to narrow, interfering with the normal flow of bile.

Ultrasound and CT-scan with injection of intravenous contrast product are the two imaging exams of choice, to be performed as the first line, to confirm the diagnosis of cholangitis.

There are two types of cholangitis:

Primary sclerosing cholangitis (CSP)

The average age at diagnosis is 40 years and men are twice as common as women. The onset of the disease is insidious and many patients are asymptomatic at the time of diagnosis

It commonly occurs in people with inflammatory bowel disease. It tends to occur in the same families, suggesting that genes may be contributing to it. An infection or damage to the bile ducts can trigger the disease in people who carry genes that make them susceptible to the disorder.

Primitive biliary cholangitis (CBP)

Nine out of ten people contracting PBC are women. It is more common in the daughters of women with cholangitis. PBC is considered an autoimmune disease and its causes remain unknown.

For both types of disease, life expectancy is on average 12 after diagnosis according to symptoms and 18 years after diagnosis asymptotimosa. 

Cholangitis is mostly asymptomatic. however, the patient may demonstrate:

• Itches
• The onset of jaundice 
• Great fatigue

In its severe form, CSP can lead to signs of liver failure and then cirrhosis or bile duct cancer: cholangiocarcinoma.

Some complications are possible: 

If the disease progresses over several years, there is a risk of scarring of the liver (cirrhosis of the liver). Risk of degeneration (formation of a malignant tumor of the bile ducts cholangiocarcinoma of the bile). Risk of development of malignant colon tumors in chronic inflammatory bowel disease.

The treatments are:

• Ursodeoxycholic acid. Because ursodeoxycholic acid is a bile acid that is virtually identical to bile acid in the body and has virtually no side effects, this medicine may improve liver function and delay the development of fibrosis (scar tissue) in the liver, which can cause damage to the liver. in turn delay or eliminate the potential for progression of PBC to liver failure and / or liver transplantation.
• Vitamins A, D, E and K can be prescribed, usually when severe jaundice is present.
• Various medications can be prescribed to reduce itching. Some examples of these drugs include: cholestyramine, antihistamines, or other drugs.
• Complications of liver damage can often be controlled. For example, a salt-restricted diet and medication (usually water pills) may be prescribed after fluid build-up in the abdomen.
• Due to cirrhosis and the risk of degeneration, an indication for liver transplantation is often required.

Certain foods help protect the liver. It’s the case :

• Probiotics. Indeed, an imbalance of the microbiota (the bacteria that colonize our intestines) is often demonstrated in liver disease.
• Omega-3, which also affects the intestinal microbiota. 
• Spices, which stimulate detoxification enzymes.
• Green tea, due to its content of polyphenols which limit damage to DNA and lower the level of lipids in the blood.
• De la vitamins E