Cholestasis (patient information)

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 * Assistant Editor-in-Chief: Meagan E. Doherty

Synonyms and Keywords: Intrahepatic cholestasis; Extrahepatic cholestasis

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

What are the symptoms of Cholestasis?
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

What causes Cholestasis?
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.

When to seek urgent medical care?
Call your health care provider if you have:
 * Persistent itching
 * Yellow skin or eyes
 * Other symptoms of cholestasis

Diagnosis

 * 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

Treatment options
The underlying cause of cholestasis must be treated.

Where to find medical care for Cholestasis?
Directions to Hospitals Treating Cholestasis

What to expect (Outlook/Prognosis)?

 * 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.

Possible complications

 * 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)

Prevention

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


 * Avoid intravenous drug use and needle sharing.