Bacterial Cholangitis: Therapy

If symptoms persist or if fever (>38.5 °C rectally) and/or jaundice (jaundice) occur, hospitalization is required.

General Measures

  • Aim for normal weight! Determination of BMI (body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program or program for the underweight.
    • BMI ≥ 25 → participation in a medically supervised weight loss program Note! Reduce excess weight slowly, as rapid weight reduction promotes gallstone formation.

Conventional non-surgical therapy methods

  • Endoscopic retrograde cholangiopancreatography (ERCP) – Diagnostic method in gastroenterology that combines endoscopy and radiology. It involves radiographic imaging of the biliary system and pancreatic duct as part of an endoscopic examination. Tissue biopsies can be obtained as well as bile aspirates. Furthermore, the procedure can be used to restore bile flow.
  • Via extracorporeal shock wave lithotripsy (ESWL), gallstones can be crushed non-surgically via shock waves. However, this method could not meet the high expectations placed on it. This is due on the one hand to the fact that only about 10 to 20 % of patients are eligible for this treatment – only stones up to 3 cm can be treated – and on the other hand to the fact that sufficient bile drainage must be ensured so that the small stone fragments can leave the body. In addition, recurrences often occur. ESWL is therefore usually combined with drug therapy. However, the shock wave lithotripsy has its permanent place in the treatment of choledocholithiasis and pancreatolithiasis (occurrence of stones in the bile duct and pancreas).

Regular checkups

  • Regular medical checkups

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
    • Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruits).
    • Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
    • High-fiber diet (whole grains, vegetables).
  • Observance of the following special dietary recommendations:
    • Diet rich in:
      • Vitamins (A, D, E, K)
  • For cholelithiasis:
    • Avoid
      • Too high calorie intake
      • Diet too rich in fat
      • High intake of refined carbohydrates
      • Low fiber diet
    • In the event of biliary colic, follow a “tea rusk diet” for 24 hours (duration: three days, longer if necessary; as long as there are no other diseases against it).
  • Selection of appropriate food based on the nutritional analysis.
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Sports Medicine