Cholestasis is a medical condition, in which stoppage or reduction of bile flow occurs. Flow of bile can be impaired at any point between the deudenum (the upper part of the small intestine) and liver cells. Even bile does not flow, and the person’s liver continues to produce bilirubin, which invades the bloodstream.

Bilirubin accumulates in the skin and passes into the urine, resulting in jaundice. The causes of Cholestasis are classified into 2 groups: Cholestasis

1. causes of cholestasis originating inside the person’s liver
2. causes of cholestasis originating outside of liver.

Causes inside the liver include Cholestasis of pregnancy, hepatitis, the effects of drugs, primary biliary cirrhosis, and alcoholic liver disease. Causes outside the liver include pancreas inflammation, stone in a bile duct, pancreatic cancer, bile duct cancer, and stricture (narrowing) of a bile duct.

The symptoms of Cholestasis include dark urine and jaundice caused by excessive bilirubin in the urine and skin. The stool can be pale because of bilirubin deficiency in the intestine and contain excessive fat (steatorrhea), because bile is not avaliable in the person’s intestine to help digest dietary fats. The bile deficiency in the intestine also meaning that vitamin D and calcium are not absorbed properly. In people with Cholestasis, the deficiency of such nutrients may result in bone loss, which may cause fractures and bone pain. Substance needed for blood clotting is also improperly absorbed, producing a tendencies to bleed easily. Bile production retention in the circulation can result in itching-with severe scratching and skin damage.

Prolonged jaundice from Cholestasis creates fatty yellow deposits in the person’s skin and muddy skin color. Cholestasis’ underlying causes show whether an individual has other symptoms, such as fever, abdominal pain, or appetite loss. To find out whether the causeĀ  is inside the liver, a physician asks patient about currently used drugs, symptoms of hepatitis, and alcohol abuse that may result in Cholestasis.

Ascites (abdominal cavity fluid), enlarged spleen and spider-like, small blood vessels seen on the skin are signs of the diseased liver cells. If causes are outside the liver, an individual can experience enlarged gallbladder, pancreas or biliary tract pain, and chills. In people with Cholestasis, the enzyme blood levels (enzyme called alkaline phospatase) are extremely high. Blood tests which measure bilirubin levels show severity of Cholestasis. A CT (computed tomography), ultrasound, or both are always performed if blood tests results appear to be abnormal. Such procedures help the physician to differ liver disease from bile ducts blockage. If the cause is found in the liver, liver biopsy can be obtained to confirm diagnosis of Cholestasis. If the cause is the bile duct blockage, an endoscopic procedure is frequently done to confirm the blockage nature.

The blockage outside the person’s liver may generally be treated with therapeutic endoscopy or surgery. A blockage found inside the liver can be treated in different ways basing on the causes. If Cholestasis is caused by drugs, the individual must stop using them. If blockage inside the liver is caused by hepatitis, then the jaundice and Cholestasis commonly disappear when the hepatitis been treated. The prescription drug Cholestyramine (which is used orally), may treat itchiness. Depending on severity of disease, using vitamin K may improve blood clotting. Additionally, Vitamin D and Calcium supplements are frequently used if Cholestasis persists. If excessive fat is excreted in the stool, the individual may be required to take supplements consisting of Triglyceride.

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