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possible bile duct blockage

  I am a 42 year old male. I have been overweight for abour 12 years
  now after leaving the Air Force.  I have been experiencing upper right quadrant
  pain in the evenings after a heavy meal, these episodes would be clustered fro about 3 days then
  go away for months.  Three days ago the pain did not subside.  The next morning they
  were still there but were bilateral just under the ribs, felt like a bruise.  This condition still
  exists.  My stool is very pale, tan or even white, my urine is very dark yellow.  My wife says my eyes
  are yellow, I feel that I have a yellowish pall to my skin, but I
  may be panicking.  I experience pain upon taking a deep breath ( unilaterally across upper abdoman)
  and awoke slightly nausous this morning.  What could this be?
Dear John,
Your symptoms are very suggestive of a blockage of the bile duct.  A very frequent cause for this problem is bile duct stones although other conditions can cause obstruction.  The history of pain after a heavy meal would make stones a likely explanation in your case.  Blockage of the duct causes jaundice (yellow eyes) dark urine and pale stool.  In some cases, there can be pancreatitis (inflammation of the pancreas) or infection of the bile ducts and liver (cholangitis).  
The other possible explanation for your symptoms is hepatitis,i.e. destruction of liver cells resulting in an inability to secrete the bile.  
It is necessary that you see a physician as soon as possible.  An ultraound of the gall bladder, bile ducts , liver and pancreas is necessary to distinguish between a bile duct and a liver cause for your jaundice. If bile duct obstruction is seen you may need an ERCP to visulize the duct and to remove the blockage.  If the ultrasound doe not show dilated ducts, then you will need a liver biopsy.
This information is presented for educational purposes only. Always consult your personal physician for specific medical questions.  If you want, we would be happy to see you in the Division of Gastroenterology at Henry Ford Health System.  Call our Physician Referral Line at (800) 653-6568 and make an appointment with Dr. Ben-Menahem, one of our experts in the treatment of bile duct problems
*keywords: common bile duct stones, jaundice

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