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Ascending cholangitis

Ascending cholangitis or acute cholangitis (or sometimes cholangitis without a modifier - from Greek chol-, bile + ang-, vessel + itis-, inflammation) is an infection of the bile duct (cholangitis), usually caused by bacteria ascending from its junction with the duodenum (first part of the small intestine). It tends to occur if the bile duct is already partially obstructed by gallstones.

Source: Wikipedia

What are the symptoms?

Within all the people who go to their doctor with ascending cholangitis, 85% report having sharp abdominal pain, 69% report having fever, and 62% report having jaundice. The symptoms that are highly suggestive of ascending cholangitis are jaundice, upper abdominal pain, stomach bloating, and vaginal itching, although you may still have ascending cholangitis without those symptoms.


What might my doctor prescribe?

Common Tests and Procedures

Patients with ascending cholangitis often receive hematologic tests, complete blood count, intravenous fluid replacement, radiographic imaging procedure, plain x-ray, kidney function tests, electrolytes panel and urinalysis .

Common Medications

The most commonly prescribed drugs for patients with ascending cholangitis include zosyn, ursodiol (urso), ceftriaxone, vancomycin, royal jelly, ceftazidime, midodrine, vitamin a, sirolimus, infliximab (remicade), candesartan (atacand), mesalamine (asacol) and tacrolimus (prograf) .

Zosyn
$520
(7 days)
Ursodiol (Urso)

Ceftriaxone
$172
(7 days)
Vancomycin
$303
(7 days)
Royal Jelly

Ceftazidime
$199
(7 days)
Midodrine
$106
(28 days)
Vitamin A
$2
(28 days)
Sirolimus
$613
(28 days)
Infliximab (Remicade)
$2995
(28 days)
Candesartan (Atacand)
$70
(28 days)
Mesalamine (Asacol)
$300
(28 days)
Tacrolimus (Prograf)
$376
(28 days)

Who is at risk?

Groups of people at highest risk for ascending cholangitis include race/ethnicity = other, age 75+ years and age 60-74 years. On the other hand, age 5-14 years and race/ethnicity = black almost never get ascending cholangitis.

Age

< 1 years
0.1x
1-4 years
0.8x
5-14 years
0.0x
15-29 years
0.2x
30-44 years
0.3x
45-59 years
1.1x
60-74 years
2.5x
75+ years
2.9x

Sex

Male
1.3x
Female
0.8x

Race/Ethnicity

Black
0.0x
Hispanic
1.3x
White
1.1x
Other
2.6x
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