is a condition involving narrowing of the bile duct
. This narrowing can cause blockage of bile
into the small intestines
Many things are associated with biliary stricture
, however it is most commonly the result of an abdominal
injury during surgery
. It can also come about as the result of pancreatitis
, abdominal trauma
in the bile duct
, an infection
from a leakage of bile
, or cancer
As mentioned above, those who have had a previous abdominal surgery
are at the highest risk. In terms of the general population
, the incidence of biliary stricture
is 2 in 10,000.
That depends. I can only speak for myself, however in talking to my doctor
and reading up on the subject I do not seem to be much different from most other sufferers (except in that I have refused the commonly accepted treatment
for the condition).
comes in attacks. The attacks (for me) tend to come between 4:00 and 9:00 AM, and there is a huge pain which extends from my belly button
to below my breast
line. I sweat
, but I shiver
, and feel nauseous
and many times will vomit
. When vomiting occurs, there is a mucousy foam, then the egg yolk
(which tastes VERY, VERY bad). After emesis
, I usually feel better. If I do not vomit
, the pain will usually last for one to three hours. This pain can be somewhat relieved by laying on my stomach
with a pillow
underneath providing pressure on the area of pain. Only on two occasions have I become jaundiced
during an attack.
With that said, the most common reported symptoms of biliary stricture
may suspect biliary stricture
if a recent cholestcystectomy patient
experiences the symptoms
noted above. The final diagnosis
is done with a procedure called endoscopic retrograde cholangiopancreatography
). An endoscope
is inserted through the mouth and down the throat
and to duodenum
while under local anesthesia
can be visualized by injecting contrast solution and monitoring via x-ray
the progress of the solution through the biliary
Most people with biliary stricture
are treated with the same ERCP
procedure which provided diagnosis, and often at the same time (often biliary stricture
is assumed by process of elimination before-hand). Special tools are inserted into the endoscope
which can cut scar tissue
, break up gallstones
, or stretch narrowed passages.
For those who do not wish to undergo the surgical procedure, in many cases nitroglycerine
can be used to halt an attack. Taken at the onset of pain, I experienced a total absence of symptoms by the time the side-effects of the nitro
wore off (a rush of headache
My doctor tells me I am chicken for not doing the ERCP. I admit it. Bawk bawk bawk. My reasoning is this: apparently that area is easily enough injured that it's a common after-effect of abdominal surgery. Thus, in my mind, it is counter-intuitive to undergo more surgery.
For myself, I have made a decision and it is not one I would recommend to anyone else suffering this condition. The pain is intense and incredible, and the ERCP is a very effective method of treatment which is usually successful.
procedure is usually succesful, and only 10% of patients will experience a recurrence of symptoms.