When particles in the digestive system form a hard ball and become lodged in the bile duct, this is called a bile duct stone, or a condition as choledocholithiasis. The most common symptom is pain on the right side of the body. Your doctor may recommend medicine to dissolve the stones or a procedure to remove them.

Bile duct, or biliary strictures are caused by the formation of scar tissue inside the bile duct. What does this do?

This causes the duct to become narrow and can block the release of bile, leading to serious complications. Scar tissue can form for many reasons, including bile duct stones, infection, injury or heavy alcohol use. The most common symptom of a bile duct stricture is pain on the right side of the body. Bile duct strictures can be biopsied and treated with a stent placed through the endoscope and sometimes require surgery.

Cholangitis is inflammation that can develop if the bile duct becomes narrow or blocked due to a bile duct stone or other obstruction. The most common symptom of cholangitis is pain on the right side of the body. Treatment options include antibiotics and a procedure to keep the bile duct open.

Solid tumors and sac-like pockets of fluid called cysts are two types of masses that can appear in or on the pancreas. These masses are often symptomless and found during a test for a different problem. Persistent abdominal pain, the feeling of a mass in your upper abdomen, nausea and vomiting are possible side effects of pancreatic masses. Pancreatic masses should be tested and monitored for signs of cancer.

Inflammation of the pancreas is called pancreatitis. It can appear suddenly and last for days or it can be chronic and occur over many years. Pancreatitis can be caused by gallstones, heavy use of alcohol, certain medications or genetic disorders. Symptoms may include upper abdomen pain that may extend to your back, fever, nausea, vomiting, rapid pulse and weight loss. Fluid collections around the pancreas can develop that sometimes require drainage through an opening created using endoscopic ultrasound into the stomach. Pancreatitis is treated with lifestyle changes, intravenous (IV) fluids, pain medicine and sometimes surgery.

When inflammation and scarring cause bile ducts in the liver to become narrowed or blocked, this is called primary sclerosing cholangitis (PSC). This condition causes bile to build up in and damage the liver, leading to symptoms like tiredness, weakness and itchy skin. This condition is serious and can result in liver failure. Treatment may include procedures to keep narrowed or blocked bile ducts open and symptom management using dietary supplements and medicine to treat infections and itchy skin.

This is a type of endoscopy, a nonsurgical procedure that helps your gastroenterologist examine and diagnose problems with your pancreas and bile ducts using a flexible tube with a camera attached. Your doctor will also take x-rays of the area as part of this procedure and may provide treatment, such as removing bile duct stones or placing stents to keep narrowed or blocked ducts open. ERCP is performed using local or general anesthesia and you will need to fast for six to eight hours prior to the procedure.

In some cases, your gastroenterologist may use a special endoscope that creates an ultrasound image of your pancreas and bile ducts, aiding in the detection of conditions that may be hard to see with the endoscopic camera. Fine needle aspiration/biopsy, in which a thin needle is used to collect a sample of cells, may also be done as part of this procedure if there is a mass, cyst, or fluid collection that needs to be tested or treated.

If an ERCP doesn’t provide enough information to diagnose or treat a problem in the bile ducts, your gastroenterologist may perform a similar procedure using a different tool, called a cholangioscope. Cholangioscopy is most often used to examine bile duct strictures or to treat difficult bile duct stones. It is performed using local or general anesthesia and you will need to fast for six to eight hours prior to the procedure.

During ERCP, your gastroenterologist may use a specialized catheter to perform a sphincterotomy, in which a small cut is made in a duct to enlarge an opening that has become narrow or blocked..