Cholestasis (patient information)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor-in-Chief: Meagan E. Doherty

Synonyms and Keywords: Intrahepatic cholestasis; Extrahepatic cholestasis

Cholestasis is any condition in which the flow of bile from the liver is blocked.

Symptoms of Cholestasis may include:

• Clay-colored or white stools
• Dark urine
• Inability to digest certain foods
• Itching
• Nausea or vomiting
• Pain in the right upper part of the abdomen
• Yellow skin or eyes

There are many causes of cholestasis.

• Extrahepatic cholestasis occurs outside the liver. It can be caused by:

• Bile duct tumors
• Cysts
• Narrowing of the bile duct (strictures)
• Stones in the common bile duct
• Pancreatitis
• Pancreatic tumor or pseudocyst
• Pressure on an organ due to a nearby mass or tumor
• Primary sclerosing cholangitis

• Intrahepatic cholestasis occurs inside the liver. It can be caused by:

• Alcoholic liver disease
• Amyloidosis
• Bacterial abscess in the liver
• Being fed through a vein (IV)
• Lymphoma
• Intrahepatic cholestasis of pregnancy
• Primary biliary cirrhosis
• Primary sclerosing cholangitis
• Sarcoidosis
• Serious infections that have spread through the bloodstream (sepsis)
• Tuberculosis
• Viral hepatitis
• Sjogren syndrome

• Certain medications can also cause cholestasis.

Call your health care provider if you have:

• Persistent itching
• Yellow skin or eyes
• Other symptoms of cholestasis

• Blood tests may show higher than normal levels of bilirubin and alkaline phosphatase.

• Imaging tests are used to diagnose this condition. Tests include:

• CT scan of the abdomen
• MRI of the abdomen
• Endoscopic retrograde cholangiopancreatography (ERCP) (can also determine cause)
• Ultrasound of the abdomen

The underlying cause of cholestasis must be treated.

Directions to Hospitals Treating Cholestasis

• How well a person does depends on the disease causing the condition. Stones in the common bile duct usually can be removed, curing the cholestasis.

• Stents can be placed to open areas of the common bile duct that are narrowed or blocked by cancers.

• Diarrhea
• Organ failure can occur if sepsis develops
• Poor absorption of fat and fat-soluble vitamins
• Severe itching
• Weak bones (osteomalacia) and osteoporosis (due to very long-term cholestasis)

• Get vaccinated for hepatitis A and B if you are at risk.

• Avoid intravenous drug use and needle sharing.

http://www.nlm.nih.gov/medlineplus/ency/article/000215.htm]

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