Cholestasis

Definition

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

Alternative Names

Causes

There are many causes of cholestasis.

Extrahepatic cholestasis -- which occurs outside the liver -- can be caused by bile duct tumors, strictures, cysts, diverticulitis, and other damage. Other potential causes for this type include stones in the common bile duct, pancreatitis, pancreatic tumor or pseudocyst, primary sclerosing cholangitis, and compression due to a mass or tumor on a nearby organ. Other causes may exist.

Intrahepatic cholestasis -- which occurs inside the liver -- can be caused by sepsis, bacterial abscess, drugs, being fed by an IV, lymphoma, tuberculosis, sarcoidosis, and amyloidosis. Other causes of this form of the disorder include primary biliary cirrhosis, primary sclerosing cholangitis, viral hepatitis, alcoholic liver disease, pregnancy, Sjogren syndrome, and others.

Please refer to drug-induced cholestasis

Symptoms

• Itching
• Jaundiced (yellow) skin or eyes
• Inability to digest certain foods
• Nausea, vomiting
• Right upper quadrant abdominal pain
• Organ failure in cases of sepsis (but not from cholestasis itself)
• Rash or fever in some cases of drug-induced cholestasis
• Clay-colored or white stools
• Dark urine

Exams and Tests

Tests that can help diagnose this condition include:

Ultrasound

CT scan

MRI

Endoscopic retrograde cholangiopancreatography (ERCP) (can also determine cause)

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

Treatment

Treatment requires addressing the underlying illness. When medications are suspected to be the cause of cholestasis, they should be stopped.

Outlook (Prognosis)

How well a person does depends on the disease causing the condition. Primary biliary cirrhosis, primary sclerosing cholangitis, and some forms of hepatitis may be treated to some extent.

Stents can be placed to open areas blocked by cancers. Cholestasis caused by medication usually goes away but can lead to liver failure.

Possible Complications

• Severe itching
• Diarrhea
• Poor absorption of fat and fat-soluble vitamins
• Fever and rash (drug-induced cholestasis)

When to Contact a Medical Professional

Call your health care provider if you have persistent itching, notice that your skin or eyes are yellow, or have other symptoms suggestive of cholestasis.

Prevention

Get vaccinated for hepatitis A and B if you are at risk. Avoid intravenous drug use and needle sharing.