Jaundice is often assumed to be a liver-related issue, but when it appears alongside abdominal pain, doctors warn that the problem may lie elsewhere, particularly in the bile duct. Ignoring this combination can delay diagnosis of a potentially serious condition.
“Jaundice with abdominal pain is a red flag,” says Dr Sanjay Khanna, Co-Chairman, Manipal Institute of Gastroenterology, Hepato-Biliary and Pancreatic Sciences, Manipal Hospitals, Dwarka. “In many cases, it points towards an obstruction in the bile duct, which requires urgent medical evaluation.”
What is bile duct obstruction?
The bile duct is a significant channel that drains the bile from the liver to the gall bladder and intestines. Bile is a significant fluid in the digestion of lipids and the removal of waste products from the body. When the bile duct is blocked, the passage of the bile will be affected, and it will accumulate in the liver.
“When obstruction is accompanied by infection or inflammation, abdominal pain often follows,” Dr Khanna explains. “Clinically, jaundice with pain is never considered harmless.”
Common causes of bile duct obstruction
Bile duct obstruction can occur due to several underlying conditions:
- Gallstones: Stones formed in the gallbladder can slip into the bile duct and block bile flow. This is one of the most common causes.
- Cholangitis: Bacterial infection or inflammation of the bile duct, which may be accompanied by fever, chills, and abdominal pain.
- Tumours: Tumors in the bile duct, pancreas, or gallbladder may slowly press against the bile duct, causing obstruction. Unintentional weight loss is also possible.
- Parasitic infections: Although very rare, parasites may enter the bile duct and cause obstruction.
- Narrowing or scarring: Previous surgeries, injuries, or chronic inflammation may cause the bile duct to narrow.
Symptoms that should raise concern
Bile duct obstruction rarely presents with just one symptom. Doctors stress the importance of recognising patterns.
Key warning signs include:
- Yellowing of the skin and eyes
- Persistent abdominal pain
- Dark-coloured urine and pale stools
- Nausea or vomiting
- Intense itching
- Fever with chills
- Loss of appetite or unexplained weight loss
“Observing these symptoms together should prompt immediate medical attention,” Dr Khanna says. “Early diagnosis allows us to address the cause before serious complications develop.”
How is bile duct obstruction treated?
Treatment depends on what is causing the blockage. If gallstones are the cause, then procedures like Endoscopic Retrograde Cholangiopancreatography (ERCP) can be employed to relieve the obstruction. In other instances, laparoscopic surgery to have the gallbladder removed may be recommended. If tumours or strictures are the cause, then stenting may be employed to keep the duct patent, followed by surgery if necessary.
Abdominal pain should never be dismissed, especially when it appears with jaundice. Together, these symptoms may be the body’s warning of bile duct obstruction, a condition that can become life-threatening if left untreated. “Timely medical intervention makes a significant difference,” Dr Khanna emphasises. “Awareness and early care can protect the liver and prevent long-term complications.”
If jaundice is accompanied by pain, the message is clear: don’t wait, get checked.
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