View source for Biliary Obstruction - Extrahepatic

== What Does It Mean? ==
Biliary obstruction-extrahepatic refers to a blockage of bile flow outside the liver, typically occurring in the common bile duct due to gallstones, strictures, tumors, or external compression. This prevents bile from reaching the small intestine, leading to fat malabsorption, impaired detoxification, and systemic inflammation.

== How Did We Get There? ==

=== Root Causes: ===
• Gallstones (Cholelithiasis) – Hardened bile components obstruct the common bile duct.

• Bile Duct Strictures – Scar tissue from previous infections, inflammation, or surgery restricts bile flow.

• Pancreatic or Biliary Tumors – Growths can physically obstruct bile movement.

• Parasitic Infections (Liver Flukes) – Certain parasites block the bile ducts.

• Inflammation-Induced Swelling – Conditions like primary sclerosing cholangitis (PSC) can reduce bile duct patency.

• Post-Surgical Complications – Prior gallbladder removal (cholecystectomy) may result in bile flow dysfunction.

=== Signs & Symptoms: ===
• Jaundice (Yellowing of Skin & Eyes) – Due to bilirubin buildup from bile duct blockage.

• Dark Urine & Pale Stools – Lack of bile pigments in the stool, excess bilirubin in urine.

• Right Upper Quadrant Pain – Biliary colic from gallstone obstruction or duct inflammation.

• Nausea, Bloating, & Poor Fat Digestion – Malabsorption of fats due to bile stasis.

• Itchy Skin (Pruritus) – Accumulation of bile acids in circulation causes irritation.

• Unexplained Weight Loss – Possible sign of malignancy-related obstruction.

=== Lab Test Findings ===
{| class="wikitable"
|'''Lab Test Name'''
|'''Expected Changes'''
|'''Optimal Range'''
|-
|Alkaline Phosphatase
|Increased
|45.00-100.00 U/L
|-
|ALT (SGOT) 
|Increased
|10.00-26.00 U/L
|-
|AST (SGOT) 
|Increased
|10.00-26.00 U/L
|-
|AST (SGOT) : ALT (SGPT) Ratio
|Increased
|0.00-1.00
|-
|Gamma Glutamyl Transferase (GGT)
|Increased
|10.00-30.00 U/L
|-
|Immature Granulocyte %
|Increased
|0.00-0.50 %
|-
|Immature Granulocyte Abs
|Increased
|0.00-0.03 Cells/µL
|}

== How Do We Treat It? ==

=== Functional Medicine Approach: ===
The goal is to restore bile flow, reduce inflammation, and support liver detoxification.

=== Supplement Protocol ===
{| class="wikitable"
|'''Supplement'''
|'''Function'''
|'''Dosage & Frequency'''
|-
|Novo Hepatic
|Improves liver detox pathways and bile flow
|1 capsule without food, daily
|-
|Advanced Vita-Biotic R
|Delivers active organisms shown to promote healthy gut flora and immune function
|1 capsule with food, daily 
|-
|Endura
|A naturally-flavored hydration powder containing essential electrolytes for endurance and hydration
|3 packets with or without food, three times daily 
|-
|CoQ-10 300 mg
|Supports cell energy production and provides wide-range antioxidant support
|2 capsules with food, daily 
|-
|Vita-Glutathione
|Master antioxidant in the body that supports healthy detoxification pathways
|1 capsule with or without food, daily 
|-
|Vita-Digestyzyme
|Supports healthy digestion while working to maintain gut balance and function
|2 capsules 20-30 minutes prior to food, daily 
|-
|Vita B Methyl
|Supports B vitamin levels for hormone balance
|1 capsule without food, daily 
|-
|Magnesium
|Aids stress response, detoxification, and hormone metabolism
|2 capsules with or without food, daily 
|-
|Vita DIM
|Promotes estrogen metabolism and detoxification
|2 capsules with or without food, daily 
|-
|Vita Defense
|Provides antioxidant protection and immune support
|1 capsule without food, daily 
|-
|Vita Buffered C Powder
|Enhances detoxification and adrenal function
|¼ scoop of powder with food, twice daily 
|-
|SBI Powder
|Helps maintain gut barrier integrity and microbiome balance
|1 scoop of powder in cold water without food, daily 
|-
|Vita Microbe
|Supports gut flora for estrogen recycling and detox
|3 capsules with or without food, daily 
|-
|D-Mannose Powder
|Aids urinary tract and vaginal microbiome health
|1 tsp of powder without food, twice daily 
|-
|Vita-Flux
|Enhances circulation and nitric oxide production
|2 capsules 20-30 minutes prior to meal, twice daily 
|-
|V-Inflamma
|Reduces systemic inflammation and oxidative stress
|1 capsule without food, daily 
|-
|Vita Candid
|Helps maintain healthy yeast balance
|2 capsules 20-30 minutes prior to food, twice daily
|-
|V-Pax
|Comprehensive multivitamin for overall health
|2 capsules with or without food, twice daily 
|-
|V-Collagen
|Supports skin, joint, and gut health
|1 scoop of powder without food, daily 
|-
|Gluta Protect
|Provides glutathione support for detoxification and immunity
|1 scoop of powder without food, daily 
|-
|Vita-Biotic
|Supports gut microbiome and immune system
|4 capsules without food, daily 
|}

=== Additional Lifestyle Interventions: ===
• Increase Bitter Foods (Dandelion, Artichoke, Milk Thistle) – Stimulates bile flow.

• Hydration & Lemon Water – Helps maintain bile fluidity.

• Low-Inflammation Diet – Reduce processed fats and increase fiber intake.

• Intermittent Fasting – Supports gallbladder contraction and detox.