What is Biliary Atresia?
Biliary Atresia is a rare disease of the liver and bile ducts mostly occurring in infants. The early symptoms of the disease start developing anytime between 2-8 weeks after birth. Bile is a liquid produced by the cells in the liver which helps digest fat. It also carries the waste from the liver to the small intestine for excretion. When an infant is suffering from biliary atresia, the bile flow from liver to gallbladder is blocked causing the bile to be trapped inside the liver, and damaging the liver cells.
There are three main types of extrahepatic biliary atresia:
- Type I: Atresia is restricted to the common bile duct
- Type II: Atresia of the common hepatic duct
- Type III: Atresia involves the most proximal part of the bile ducts (>95% of all cases)
What are the symptoms of Biliary Atresia?
Initially, the symptoms of Biliary Atresia are non-distinguishable to neonatal jaundice. Children and infants with biliary atresia begin to show particular symptoms of the disease from 2-8 weeks of their birth onwards. When the bile fails to drain from the liver due to blockage, it starts to build up inside and causes damage and scarring of liver cells.
The symptoms of Biliary Atresia include:
Treatment of Biliary Atresia
Which specialty of doctor is to be consulted for the treatment of Biliary Atresia in India?
Which hospital is to be preferred for the treatment of Biliary Atresia in India?
1. What are the causes of Biliary Atresia?
The causes and reasons of biliary atresia are not completely understood. But in some cases, the incomplete development of bile duct in the mother's womb could be a reason, or the bile ducts could be affected due to a virus infection in perinatal period. Also, there are no links to medications taken during pregnancy. It is evident that 10-15% of infants with biliary atresia are born with abnormalities in the:
- Blood vessel (inferior vena canal anomalies)
- Intestinal (malrotation)
- Spleen (Polysplenia)
Various researches have suggested that there can be either viral, toxin or genetically related damage to the biliary pathways.
2. What are the risk factors associated with biliary atresia?
The main risk factors associated with biliary atresia are:
- Genetic factors
- Environmental toxins
3. What can be the possible ways to prevent biliary atresia?
To prevent the occurrence of biliary atresia, one should take care of:
- Sleep hours
- Physical fitness
- Eating habits
4. How is biliary atresia diagnosed?
- At Medanta - The Medicity hospital in India, diagnosis is made based on symptoms, physical examination, and medical history of the patient using blood tests, biopsy of liver, and imaging for a better and clearer picture.
Blood tests confirm liver function abnormalities and identify the cause of jaundice.
5. How is biliary atresia treated?
- Biliary Atresia cannot be treated with medication. Other treatment option include:
- Removal of damaged ducts
- The surgeon removes the damaged ducts outside the liver and identifies smaller ducts still open and draining bile. A loop of intestine is then attached to these open ducts for proper drainage and flow of bile from healthy ducts.
- Long Term Antibiotic Therapy
- Long Term Antibiotic Therapy is prescribed for avoiding any infection along with additional medications to maximize the success of the operation. In cases where Kasai procedure is not successful, liver transplant is the only solution. Success of the procedure is dependent on:
- Age: Younger the infant, greater the success rates of operation
- Extent of Liver damage
- Number and size of functional and healthy ducts
- Experience of the surgical and medical team
6. How common is Biliary Atresia ?
- Biliary Atresia occurs in 1 in 10,000 to 20,000 live births. Biliary Atresia is one of the commonest causes of neonatal jaundice.
7. Is Biliary Atresia an inheritable disease?
- Biliary Atresia is not an inheritable condition. So if one baby suffers from Biliary Atresia then there is very small chance that the other sibling may also suffer from this same disease.