Biliary Disease

Overview

Biliary disease is a group of conditions that affect your bile ducts, gallbladder, and other parts of the system that makes and moves bile. Bile is a fluid made by your liver that helps you digest fats. When this system gets blocked or inflamed, it can cause pain, infection, and other problems.

Yes. Gallstones are very common, affecting about 1 in 10 adults in the UK. Most people with gallstones do not know they have them until they cause symptoms.

Biliary disease can affect anyone, but it is more common in women, people over 40, people who are overweight, and those with certain conditions such as diabetes or a family history of gallstones.

Symptoms

Common symptoms

• Pain in the upper right side or center of the belly, often after eating a fatty meal
• Dull or sharp pain under the right shoulder blade
• Nausea and vomiting
• Indigestion, bloating, or a feeling of fullness
• Jaundice — a yellow tint in the skin or eyes
• Dark urine and pale or greasy stools
• Fever and chills if there is an infection

Symptoms in children

• Fussiness or poor feeding in babies
• Yellowing of the skin and eyes
• Slow weight gain or failure to thrive
• Vomiting and belly pain
• Frequent infections of the bile ducts

Symptoms in older adults

• Confusion or sudden changes in mental state
• Less specific symptoms like tiredness or lethargy
• High fever with mild or no belly pain
• Feeling generally unwell without obvious cause
• Nausea and poor appetite

Causes

Main causes

• Gallstones blocking the bile ducts
• Inflammation of the gallbladder (cholecystitis)
• Infection in the bile ducts (cholangitis)
• Narrowing or scarring of the bile ducts from injury or disease
• Tumors or growths that press on the bile ducts
• Congenital conditions that affect how the bile ducts are formed

Risk factors

• Being female
• Being over 40 years old
• Pregnancy
• Rapid weight loss
• Obesity or being overweight
• Eating a diet high in fat and cholesterol and low in fiber
• Having diabetes or metabolic syndrome
• A family history of gallstones
• Liver disease or cirrhosis

When to see a doctor

See a doctor urgently if:

• You have sudden, severe pain in your belly that lasts more than a few hours
• You have a fever with jaundice
• You are vomiting and cannot keep fluids down
• Your skin or eyes look yellow
• You notice dark urine and pale stools

Book a routine appointment if:

• You have mild belly pain after meals that keeps happening
• You feel bloated, nauseated, or have indigestion more often than usual
• You have a family history of bile duct or gallbladder disease and want to know your risk
• You are due for a general check-up and have concerns about gallstones

Diagnosis

Your healthcare provider will start by asking about your symptoms and your medical history. They will also do a physical exam, checking your belly for pain or swelling. Based on this, they may recommend one or more tests to look at your gallbladder and bile ducts.

Tests that may be done

• Blood tests to check liver function and look for signs of infection
• Ultrasound of the belly, which uses sound waves to create images of your gallbladder and bile ducts
• CT scan for more detailed images of your organs
• HIDA scan, an imaging test that tracks the flow of bile from your liver into your intestines
• ERCP, an endoscopic procedure that lets the doctor look at your bile ducts and sometimes remove blockages

What to expect at your appointment

Many tests for biliary disease are painless or cause only mild discomfort. Blood tests simply involve a needle in your arm. Ultrasound and CT scans are non-invasive. If you need an ERCP, you will be given medicine to help you relax, and the test usually takes about an hour. Your healthcare team will explain each step before you go through it.

Treatment

Treatment for biliary disease depends on the cause, your symptoms, and how severe the condition is. If you have gallstones but no symptoms, you may not need any treatment at all. If you have pain or complications, there are several safe and effective options.

Self-care at home

• Eat smaller, more frequent meals to ease strain on your digestive system
• Avoid fried, greasy, or very fatty foods that can trigger pain
• Drink plenty of water
• Rest if you feel unwell or have pain
• Keep a food diary to identify foods that make your symptoms worse

Medical treatments

Your healthcare team may offer pain relief, antibiotics for infections, or medicines to help your body manage bile flow. Some treatments are given directly to the bile ducts through a tube during a procedure like ERCP. The goal is to relieve symptoms, clear any blockages, and treat infections. Only a doctor can decide which treatment is right for you.

When is surgery considered?

If you have repeated gallbladder attacks, a blockage, or other complications, surgery may be recommended. The most common operation is to remove the gallbladder. It is a very common procedure, and most people live normally without a gallbladder.

Living with this condition

Most people with biliary disease can live a full and active life. If you have symptoms, it may help to plan your meals and avoid foods that trigger pain. You may need to adjust your eating habits and manage stress, but with the right support, you can stay well.

Lifestyle tips

• Maintain a healthy weight for you
• Lose weight gradually if you are overweight, rather than very quickly
• Stay physically active most days of the week
• Avoid heavy alcohol use
• Manage other health conditions like diabetes or high cholesterol with your healthcare team

Diet and exercise

Eat a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Limit saturated fats and processed foods. Regular exercise, like walking or swimming, helps keep your digestion healthy and supports weight management. Always talk to your doctor before starting a new exercise plan.

Mental health and emotional wellbeing

Living with a chronic health condition can sometimes feel stressful or overwhelming. Belly pain and dietary changes can affect your mood and social life. It is okay to feel frustrated or anxious. Talking to a counsellor, joining a support group, or simply sharing your feelings with people you trust can make a real difference.

Prevention

You cannot always prevent biliary disease, but you can lower your risk. Maintaining a healthy weight, eating balanced meals, and avoiding extreme or rapid weight loss help protect your bile system. Regular physical activity also supports healthy digestion and reduces the chance of gallstones.

Complications

If left untreated

• Inflammation of the gallbladder (cholecystitis) – infection and swelling that can lead to an abscess
• Infection of the bile ducts (cholangitis) – a severe infection that can spread to the bloodstream
• Pancreatitis – painful inflammation of the pancreas caused by a blocked bile duct
• Jaundice – yellowing of the skin and eyes due to bile backing up into the blood
• Liver damage – prolonged blockage can harm the liver over time

Long-term outlook

With prompt and proper care, most biliary disease can be managed successfully. Surgery to remove the gallbladder is safe and allows most people to return to their normal activities without lasting problems. If a condition is found early, complications are much less likely. Your healthcare team will work with you to create the best plan for your situation, and many people live very well after treatment.

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