Etiology and Pathogenesis of Inflammatory Diseases of the Biliary Tract: A Hypothesis

Dorot. Medical Center for Rehabilitation and Geriatrics, Netanya, Israel

*Corresponding Author: Michael D Levin, MD, Ph.D, Dorot. Medical Center for Rehabilitation and Geriatrics, Department of Pediatric Radiology of the 1-st State Hospital, Minsk, Belarus, Dorot. Medical Center for Rehabilitation and Geriatrics, Amnon veTamar, Netanya, Israel, Tel: 972-538281393, Email: [email protected]

Received Date: November 25, 2025

Published Date: December 26, 2025

Citation: Levin MD. (2025). Etiology and Pathogenesis of Inflammatory Diseases of the Biliary Tract: A Hypothesis. Mathews J Gastroenterol Hepatol. 10(3):37.

Copyrights: Levin MD. © (2025).

ABSTRACT

All articles devoted to the pathology of the biliary tract provide risk factors, which are listing clinical, histological, and other characteristics associated with acute and chronic cholecystitis with and without stones, as well as with acute obstructive cholangitis. These factors are unrelated to the etiology of the disease; however, the causes of biliary tract pathology are not given at all. Each nosologically entity is described as a separate disease, as if gallbladder dyskinesia and cholelithiasis are not stages of pathogenesis. We analyzed the literature and our own research to determine the etiology and pathogenesis of biliary system diseases. We provide evidence that biliary pathology arises from hydrochloric acid hypersecretion. Therefore, it is associated with other acid-dependent diseases, including gastroesophageal reflux disease and inflammation (ulcers) of the stomach and duodenum. Hypersecretion of hydrochloric acid causes dyskinesia of the sphincter of Ochsner, leading to increased pressure in the duodenum, where the sphincter of Oddi opens. This leads to increased pressure in the common duct and its dilation, stagnation of bile in the gallbladder, increased bile concentration, and stone formation. Dysfunction of the sphincter of Oddi and the common duct leads to periodic reflux of duodenal chyme and bacteria into the bile ducts. The disease progresses from dyskinesia to stone formation and acute inflammation. Stone formation and symptoms are most often observed after age 40, as dyskinesia can present asymptomatically or overlap by symptoms of other acid-related diseases. Discussion of this hypothesis will help select more rational methods for diagnosing and treating biliary tract pathologies.

Keywords: Hydrochloric Acid Hypersecretion, Biliary Tract Pathology, Cholecystitis, Gallstones, Sphincter Oddi Dysfunction, Sphincter Ochsner Dyskinesia, Etiology and Pathogenesis.