Learn About Cholestasis

What is the definition of Cholestasis?

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

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What are the alternative names for Cholestasis?

Intrahepatic cholestasis; Extrahepatic cholestasis

What are the causes of Cholestasis?

There are many causes of cholestasis.

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

  • Bile duct tumors
  • Cysts affecting the bile duct
  • Narrowing of the bile duct (strictures)
  • Stones in the common bile duct
  • Pancreatitis
  • Pancreatic tumor or pseudocyst
  • Pressure on the bile ducts 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 exclusively through a vein (IV)
  • Lymphoma
  • Pregnancy
  • Primary biliary cholangitis (previously called primary biliary cirrhosis)
  • Primary or metastatic liver cancer
  • Primary sclerosing cholangitis
  • Sarcoidosis
  • Serious infections that have spread through the bloodstream (sepsis)
  • Tuberculosis
  • Viral hepatitis

Certain medicines can also cause cholestasis, including:

  • Antibiotics, such as ampicillin and other penicillin
  • Anabolic steroids
  • Birth control pills
  • Chlorpromazine
  • Cimetidine
  • Estradiol
  • Imipramine
  • Prochlorperazine
  • Terbinafine
  • Tolbutamide
What are the symptoms of Cholestasis?

Symptoms may include:

  • Clay-colored or pale 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
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What are the current treatments for Cholestasis?

The underlying cause of cholestasis must be treated.

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What is the outlook (prognosis) for Cholestasis?

How well a person does depends on the disease causing the condition. Stones in the common bile duct can often be removed. This can cure the cholestasis.

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

If the condition is caused by the use of a certain medicine, it will often go away when you stop taking that drug.

What are the possible complications of Cholestasis?

Complications may include:

  • Diarrhea
  • Organ failure can occur if sepsis develops
  • Poor absorption of fat and fat-soluble vitamins
  • Severe itching
  • Weak bones (osteomalacia) due to having cholestasis for a very long time
When should I contact a medical professional for Cholestasis?

Contact your health care provider if you have:

  • Itching that does not go away
  • Yellow skin or eyes
  • Other symptoms of cholestasis
How do I prevent Cholestasis?

Get vaccinated for hepatitis A and B if you are at risk. Do not use intravenous drugs and share needles.

What are the latest Cholestasis Clinical Trials?
RESPONSE: A Placebo-controlled, Randomized, Phase 3 Study to Evaluate the Efficacy and Safety of Seladelpar in Patients With Primary Biliary Cholangitis (PBC) and an Inadequate Response to or an Intolerance to Ursodeoxycholic Acid (UDCA)

Summary: To evaluate the treatment effect of seladelpar on composite biochemical improvement in cholestasis markers based on ALP and total bilirubin and to evaluate the safety of seladelpar over 12 months of treatment compared to placebo

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A Prospective Prevalence Study in Adolescent and Adult Patients Dependent on Parenteral Nutrition to Assess the Incidence of Intestinal Failure-Associated Liver Disease

Summary: This is a multi-center prospective cross-sectional observational study that will assess the prevalence of liver disease in patients dependent on parenteral nutrition (PN) for 4 or more days per week. Liver disease will be determined by the presence of choline deficiency, cholestasis (confirmed by elevated serum alkaline phosphatase (ALP) liver isoenzyme level), and steatosis (confirmed by magnetic...

What are the Latest Advances for Cholestasis?
A rare case of acute liver failure with intrahepatic cholestasis due to dengue hemorrhagic fever: CytoSorb® and plasma exchange aided in the recovery: case report.
The Inconvenient Truth of Primary Biliary Cholangitis/Autoimmune Hepatitis Overlap Syndrome.
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A prospective pilot study of a gluten-free diet for primary sclerosing cholangitis and associated colitis.
Who are the sources who wrote this article ?

Published Date: May 04, 2022
Published By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Eaton JE, Lindor KD. Primary biliary cholangitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 91.

Fogel EL, Sherman S. Diseases of the gallbladder and bile ducts. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 146.

Lidofsky SD. Jaundice. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 21.