Digestive Diseases and Conditions

Your liver is the largest organ inside your body. It is also one of the most important. The liver has many jobs, including changing food into energy and cleaning alcohol and poisons from the blood. Your liver also makes bile, a yellowish-green liquid that helps with digestion.

Biliary and Gall Stones: According to the American Gastroenterological Association, gallstone disease is a common medical problem, affecting 10-15% of the U.S. population. The gallbladder is a sac that lies on the undersurface of the liver. It is connected to the liver and the intestine by small tubes, or ducts. The primary job of the gallbladder is to store bile, which is secreted continuously by the liver, until the bile is needed to aid in digestion. Gallstones are pieces of hard solid matter in the gallbladder that form when components of bile form into crystals. Sometimes the crystals and stones are too small to see with the naked eye. This condition is called biliary sludge.

The most typical symptom of gallstone disease is severe steady pain in the upper abdomen or right side. The pain may also be felt between the shoulder blades or in the right shoulder. Sometimes patients also have vomiting or sweating. It is thought that gallstone pain results from blockage of the gallbladder duct (cystic duct) by a stone. When the blockage is prolonged (greater than several hours), the gallbladder may become inflamed. This condition is called acute cholecystitis.

More serious complications may occur when a gallstone passes out of the gallbladder duct and into the main bile duct. If the stone lodges in the main bile duct, it can lead to a serious bile duct infection. If it passes down the bile duct, it can cause an inflammation of the pancreas, which has a common drainage channel with the bile duct. Either of these situations can be extremely dangerous.

The most accurate tests to identify stones in the bile duct include: Magnetic resonance imaging (MRI) scans, Endoscopic ultrasound (EUS), and Endoscopic retrograde cholangiopancreatography (ERCP). During ERCP, if the gastroenterologist finds stones in the bile then these stones may be removed endoscopically.

Cirrhosis: Cirrhosis is a permanent injury of the liver resulting from chronic liver diseases. It results in the inability of the liver to function properly in its role of processing nutrients, hormones, drugs and toxins. Fatigue, exhaustion, loss of appetite and weakness are symptoms. Nausea and weight loss may also be experienced, and in the later stages, the patient may have jaundice (yellow skin), bleeding or a swollen belly. Diagnosis may require lab tests, ultrasound, scans, or a biopsy of the liver.

Cholangitis: Cholangitis is an infection of the common bile duct, the tube that carries bile from the liver to the gallbladder and intestines. Cholangitis is usually caused by a bacterial infection, which can occur when the duct is blocked by something, such as a gallstone or tumor. The infection causing this condition may also spread to the liver. Risk factors include a previous history of gallstones, sclerosing cholangitis, HIV, narrowing of the common bile duct, and, rarely, travel to countries where you might catch a worm or parasite infection. Antibiotics to cure infection are tried first for most patients. ERCP or other surgical procedure is done when the patient is stable. Patients who are very ill or are quickly getting worse may need surgery right away.

Hepatitis: Hepatitis is a contagious disease caused by viruses or other conditions that attack the liver causing inflammation and sometimes permanent damage to the liver. Hepatitis A is caused by ingesting contaminated food or water. Although patients can become quite ill with Hepatitis A, this disease is rarely life threatening and never becomes chronic. Hepatitis B is one of the most serious types of hepatitis. Spread through infected blood, needles and sexual contact, this disease is a major health problem. Hepatitis B can become chronic and may lead to cirrhosis or liver cancer. Treatments are available for chronic Hepatitis B. There is a vaccine that can prevent this disease. Hepatitis C is also transmitted through infected blood and needles, but rarely is spread through sexual contact. It frequently becomes chronic and may slowly destroy the liver. Treatment is available that can eliminate the virus in some individuals. There is no vaccine for Hepatitis C.
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