Cholangitis epidemiology and demographics

Cholangitis is most prevalent in adults, with roughly 20% of the population suffering from some form of abdominal pain from gallstones passing through the bile duct into the digestive tract.

• Within a span of ten years, 15–26% of people will suffer at least one episode of biliary colic (abdominal pain due to the passage of gallstones through the bile duct into the digestive tract).^[1]
• 2–3% of people will develop complications of obstruction in the form of acute cholangitis.
• The prevalence of gallstones increases with age and body mass index.
• The risk is also increased in those who lose weight rapidly (after bariatric surgery, for example) due to alterations in the composition of the bile that makes it prone to form stones.

• In 1980, the mortality rate of acute cholangitis was more than 50000 per 100,000 individuals; 10000-30000 per 100,000 individuals in 1981-1991; 2700-10000 per 100,000 individuals after the year 2000.^[2][3][4]

• The condition mostly occurs in adults, with a reported median age at onset of 50-60 years.^[1]

• Gallstones are slightly more common in women than in men, and pregnancy increases the risk further.^[1]
• The increased prevalence of gallstones in women is due to hormonal imbalance between estrogen and progesterone.

• There is no racial predilection to cholangitis.

• In Western countries, about 15000 per 100,000 individuals have gallstones in their gallbladder, but the majority are unaware of this and have no symptoms.^[1]
• Incidence rates range between 0.41 and 1.2 per 100,000 people per year.^[5]

• Parasites, specifically including the species Ascaris, Opisthorchis, Clonorchis, Fasciola and Echinococcus, are commonly associated with cholangitis outside of the United States.^[6]
  • Ascaris is thought to be the etiologic agent of recurrent pyogenic cholangitis found in Hong Kong, Southeast Asia, Columbia, Italy, and South Africa.

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