bile duct obstruction

I am 72 years old.  After my cholecystectomy in 1979 I had digestive problems unknown to me before the surgery.  I have reduced these with careful attention to diet and weight.  My bowl movements look noral but are are usually distinctly yellow in color on the tissue.  I also have a hard to describe sensation--probably esophageal and akin to mild, but uncomfortable burning when I awake from sleep, especially a nap. Elevating the head of my adjustable bed does not help. (I have no known history of GERD.)  Stool studies several years ago always suggested bile duct obstruction, but there was no definitive diagnosis or suggested treatment.

I am wondering if the symptoms I describe are consistent with biliary obstruction, and if so, if I should ask my physician to address them, or simply live with them as I have been doing. I can certainly live with them if I am not endangering myself by not addressing them specifically.

Thank you for any comments or suggestions you may have--especially dietary. The only prescription drugs I use are levothyroxin (levothyroxine), cytomel (both low dosage) and methylcobalamin with folic acid IM.

[CalGal]

Symptoms of bile duct obstruction - periodic - are stools that are grayish or whitish when the flow of bile is being obstructed due to a spasm and when the spasm has stopped many people end up with loose, runny stools that can be yellow and sometimes feel like they're burning. If the bile duct spasms, most people find they're in intense pain, much like they would be during a gallbladder attack. When someone is in pain, that's the point when blood tests should be done to check for elevated liver and pancreatic enzyme levels. It's a good starting point so the doc will know that 'something' is going on.

If you're having spasms, and they can either see the spasms on an MRCP (an 'easy' test) or see changes going on in the bile duct - or even possiblly see sludge (not usual) or small stones in the bile duct - they'll suggest you have an ERCP done. In that test they'll introduce a scope into the bile duct to clean out the duct and check for any other changes that can be seen. The problem with the ERCP is it is invasive and it is possible to develop pancreatitis after the test, but they try to reduce that probability by using a stent.

Some people find that if they limit their intake of fat it might help. Others who don't want to undergo an ERCP try various anti-spasm meds. They work for some, but not others.

I would think in a doc's mind he should question whether or not you are having spasms, and if you are, if an 'backup' of bile is injuring either your liver or your pancreas. You may want to check with your doc about that. You do NOT want to injure either of those organs, but especially the pancreas.

Talk with your doc.