What does cholestasis mean in medical terms?
Topic Resources. Cholestasis is reduction or stoppage of bile flow. Disorders of the liver, bile duct, or pancreas can cause cholestasis. The skin and whites of the eyes look yellow, the skin itches, urine is dark, and stools may become light-colored and smell foul.
What causes cholestasis of the liver?
Various conditions of the liver, the bile duct, or the pancreas can cause a decrease in the flow of bile and result in cholestasis. An obstruction in the flow of any of the substances that make up bile (including bile salts, bile acids, and more) can result in cholestasis.
What is cholestatic hepatitis?
Bilirubin is the substance that causes jaundice, or the yellow-orange color of someone with a serious liver problem. If you put these two terms together, it’s easy to see that “cholestatic hepatitis” is any form of liver disease that causes inflammation of the liver and a problem with bile transport.
What is cholestasis in primary sclerosing cholangitis?
Chronic cholestasis is a feature in primary sclerosing cholangitis (PSC). PSC is a rare and progressive cholestatic liver disease characterized by narrowing, fibrosis, and inflammation of intrahepatic or extrahepatic bile ducts, leading to reduced bile flow or formation (i.e., cholestasis).
Is obstetric cholestasis dangerous?
Obstetric cholestasis can be a serious condition for both mom and baby. While most cases are nonthreatening, it can cause serious complications, including:
What are the two types of cholestasis?
There are two types of cholestasis: intrahepatic cholestasis and extrahepatic cholestasis. Intrahepatic cholestasis originates within the liver. It can be caused by: disease. infection. drug use. genetic abnormalities. hormonal effects on bile flow. Pregnancy can also increase your risk for this condition.
What is the function of bile in the body?
Bile is fluid produced by your liver that aids in the digestion of food, especially fats. When bile flow is altered, it can lead to a buildup of bilirubin. Bilirubin is a pigment produced by your liver and excreted from your body via bile. There are two types of cholestasis: intrahepatic cholestasis and extrahepatic cholestasis.
Why does my cholestasis itch?
The most common symptom of obstetric cholestasis is itching without a rash. This is caused by the buildup of bile acids in the blood. The itching generally occurs in the last trimester of pregnancy. It can also be accompanied by: jaundice. pale stools.
What causes extrahepatic cholestasis?
Extrahepatic cholestasis is caused by a physical barrier to the bile ducts. Blockages from things like gallstones, cysts, and tumors restrict the flow of bile. Read on to learn more about this condition.
How to treat cholestasis?
Treatment. The first step to treating cholestasis is to treat the underlying cause. For example, if it’s determined that medication is causing the condition, your doctor may recommend a different drug. If an obstruction like gallstones or a tumor is causing the backup of bile, your doctor may recommend surgery.
What tests are done to determine cholestasis?
Your doctor will ask questions about your medical history. You’ll also have a physical exam. Blood tests may be ordered to test for liver enzymes that indicate cholestasis. If test results are abnormal, your doctor may order imaging tests like ultrasound or MRI. Your doctor may also perform a liver biopsy.
What is intrahepatic cholestasis?
Intrahepatic cholestasis is characterized by widespread blockage of small ducts or by disorders, such as hepatitis, that impair the body's ability to eliminate bile. Extrahepatic cholestasis can occur as a side effect of many medications. It can also occur as a complication of surgery, serious injury, tissue-destroying infection, ...
What is cholestasis in the body?
Cholestasis is a condition caused by rapidly developing (acute) or long-term (chronic) interruption in the excretion of bile (a digestive fluid that helps the body process fat). The term is taken from the Greek chole, bile, and stasis, standing still.
What causes cholestasis in the liver?
Cholestasis is caused by obstruction within the liver (intrahepatic) or outside the liver (extra hepatic). The obstruction causes bile salts, the bile pigment bilirubin, and fats (lipids) to accumulate in the blood stream instead of being eliminated normally.
What is the name of the drug that causes yellow spots on the skin?
ranitidine (Zantac) sulfonamides (Apo-Sulfatrim, sulfamethoxazole) sulindac (Clinoril, Saldac) Symptoms of both intrahepatic and extrahepatic cholestasis include a yellow discoloration of the skin (jaundice), dark urine, and pale stools. Itching over the skin may be severe if the condition is advanced.
When should cholestasis be considered a cancer?
Cancer should be considered when an adult suddenly develops cholestasis after the age of 50.
What are the three liver tests?
Special attention should be paid to three liver function tests. Levels of alkaline phosphatase (ALP), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) can indicate whether the patient's condition is caused by an obstructive condition like cholestasis or a disease of the liver cells (hepatocellular disease) like viral hepatitis or cancer. ALP levels more than three times greater than normal indicate cholestasis. High levels of AST and particularly of ALT, which is found predominantly in liver cells, indicate hepatocellular disease.
What does ALT mean in a blood test?
Levels of alkaline phosphatase (ALP), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) can indicate whether the patient's condition is caused by an obstructive condition like cholestasis or a disease of the liver cells (hepatocellular disease) like viral hepatitis or cancer.
What causes cirrhosis in the liver?
Within the liver. Causes include acute hepatitis , alcohol-related liver disease , primary biliary cholangitis with inflammation and scarring of the bile ducts, cirrhosis due to viral hepatitis B or C (also with inflammation and scarring of the bile ducts), certain drugs (for example, amoxicillin/clavulanate, chlorpromazine, azathioprine, ...
What is the name of the sac that holds bile?
Gallbladder and Biliary Tract The gallbladder is a small, pear-shaped, muscular storage sac that holds bile and is interconnected to the liver by ducts known as the biliary tract. (See also Overview of the Liver and Gallbladder... read more
Why does my skin turn yellow?
Jaundice is a yellow color of the skin and eyes that results from excess bilirubin deposited in the skin, and dark urine results from excess bilirubin excreted by the kidneys. The skin itches, possibly because bile products accumulate in the skin. Scratching can damage the skin.
Why do my bowels turn light colored?
Stools may become light-colored because the passage of bilirubin into the intestine is blocked, preventing it from being eliminated from the body in stool. Stools may contain too much fat (a condition called steatorrhea) because bile cannot enter the intestine to help digest fat in foods.
How to treat a blocked bile duct?
A blockage of the bile ducts can usually be treated with surgery or endoscopy (using a flexible viewing tube with surgical instruments attached).
What does it mean when you have no bile?
The lack of bile in the intestine also means that calcium and vitamin D are poorly absorbed. If cholestasis persists, a deficiency of these nutrients can cause loss of bone tissue. Vitamin K, which is needed for blood clotting, is also poorly absorbed from the intestine, causing a tendency to bleed easily.
What causes a bile duct to narrow?
Causes include a stone in a bile duct, narrowing (stricture) of a bile duct, cancer of a bile duct, cancer of the pancreas, and inflammation of the pancreas ( pancreatitis ).
What causes cholestasis in the liver?
An obstruction in the flow of any of the substances that make up bile (including bile salts, bile acids, and more) can result in cholestasis. Causes of cholestasis may include a problem with the liver itself, or a condition occurring outside of the liver. Causes Within the Liver (Intrahepatic): Acute hepatitis.
Why does cholestasis occur?
This can happen for several different reasons. Cholestasis can occur from impairment of bile secretion from the liver cells, an obstruction that blocks the flow of bile, or a combination of the two. Bile is a greenish-brown fluid that aids in digestion and is secreted by the liver and stored in the gallbladder.
What is a gallstone?
Gallstone: An abnormal, small, hard mass made of bile pigments, cholesterol and calcium salts, which is formed in the gallbladder or bile ducts. Gallstones can cause a blockage of the bile duct (resulting in severe pain and cholestasis).
What are the symptoms of cholestasis?
Jaundice and itchy skin are the two most characteristic symptoms of cholestasis. Foul-smelling and/or light-colored stool (from a blockage of bilirubin into the intestine) Steatorrhea (too much fat in the stool from the inability of the bile to digest fats in the intestine)
Why does bilirubin turn yellow?
When the flow of bile is blocked or reduced for any reason, bilirubin begins to escape into the bloodstream and starts to build up, which eventually causes the yellowish hue to the skin and whites of the eyes, as found in jaundice. 1 . Jaundice and itchy skin are the two most characteristic symptoms of cholestasis.
How to treat cholestasis?
Treatment of cholestasis depends on the underlying cause, these include: Medication, such as cholestyramine, to relieve the itching of the skin. Surgery or endoscopy (a flexible viewing tube with a surgical instrument attached) to correct blockages of the bile duct.
What is the term for a person who has too much fat in their stool?
Steatorrhea (too much fat in the stool from the inability of the bile to digest fats in the intestine) Low calcium and vitamin D levels and other nutrients (if cholestasis is long-term) Muddy-colored skin, fatty yellow deposits in the skin (form long-term cholestasis)
What antibiotics cause cholestatic liver injury?
Among antibiotics and antifungals, common drugs implicated in DIC are penicillins, macrolides, trimethoprim/sulfamethoxazole, and tetracyclines. The penicillin amoxicillin-clavulanate is the most common culprit of cholestatic liver injury, which occurs as a result of the clavulanic acid component. Flucloxacillin, commonly prescribed in the UK, Sweden, and Australia, is another penicillin frequently involved. Cholestasis induced by penicillins usually resolves after withdrawal. Macrolides with the potential to cause DIC include erythromycin, clarithromycin, and azithromycin; prognosis is likewise favorable. Trimethoprim/sulfamethoxazole, due to its sulfonamide component, is the fourth most common antibiotic responsible for DILI in North America. DIC is comparatively less common for low-dose tetracyclines (e.g., doxycycline). Other antimicrobials include the antifungal terbinafine, notable for its potential to cause life-threatening cholestatic injury, and quinolones (ciprofloxacin, levofloxacin), which have been linked to cholestatic hepatitis and vanishing bile duct syndrome. Among psychotropic drugs, chlorpromazine is well-known to cause cholestatic hepatitis, as can tricyclic antidepressants (imipramine, amitriptyline) and SSRIs (duloxetine). Anti-inflammatory drugs with cholestatic potential include the immunosuppressant azathioprine, reported to cause fatal cholestatic hepatitis, and the NSAID diclofenac.
How do drugs induce cholestasis?
Drugs may induce cholestasis by interfering with 1) hepatic transporters, 2) bile canaliculi dynamics, and/or 3) cell structure and protein localization. Hepatic transporters are an essential mechanism in the maintenance of enterohepatic bile flow and bile acid homeostasis. Therefore, drugs that directly inhibit these transporters are expected to induce cholestasis. The most relevant transporters that targeted by drugs are BSEP, MDR3, MRP2-4, and NTCP.
What is cholestasis in the liver?
Cholestasis is a condition where bile cannot flow from the liver to the duodenum. The two basic distinctions are an obstructive type of cholestasis where there is a mechanical blockage in the duct system that can occur from a gallstone or malignancy, and metabolic types of cholestasis which are disturbances in bile formation that can occur because of genetic defects or acquired as a side effect of many medications. Classification is further divided into acute or chronic and extrahepatic or intrahepatic.
How to treat cholestasis?
Extrahepatic cholestasis can usually be treated by surgery. Pruritus in cholestatic jaundice is treated by antihistamines, ursodeoxycholic acid, and phenobarbital. Nalfurafine hydrochloride can also treat pruritus caused by chronic liver disease and was recently approved in Japan for this purpose.
What is the best test for cholestasis?
With a few exceptions, the optimal test for cholestasis would be elevations of serum bile acid levels. However, this is not normally available in most clinical settings.
Why is GGT elevated?
GGT is elevated because it leaks out from the bile duct cells due to pressure from inside bile ducts. In a later stage of cholestasis aspartate transaminase (AST), alanine transaminase (ALT) and unconjugated bilirubin may be elevated due to hepatocyte damage as a secondary effect of cholestasis.
How to treat extrahepatic cholestasis?
Extrahepatic cholestasis can usually be treated by surgery.
What does it mean when an infant has acholic stools?
This cholestatic liver disease affects infants during the first couple of weeks of their lives. Your infant will develop jaundice and have acholic stools, dark urine, and hepatomegaly. Chronic pruritus is also a common symptom and usually indicates a deficiency of fat-soluble vitamins.
What is the treatment for cholestatic liver disease?
Treatment: Your doctor will check the presence of anti-mitochondrial antibodies to make a diagnosis. Once confirmed, they will treat this cholestatic liver disease with ursodeoxycholic acid (UDCA), which is the only medication available and is effective in 60% of patients. The rest have a high risk of developing liver insufficiency and cirrhosis. They require liver transplantation.
What is the cause of bile duct inflammation?
Primary Sclerosing Cholangitis (PSC) This affects extra and intra-hepatic bile ducts and causes inflammation in the bile ducts. This causes narrowing of the bile ducts, which leads to a buildup of bile in the liver. The buildup causes damage to liver cells and results in cancer or cirrhosis. Symptoms: Abdominal pain and pruritus are ...
Why is bile important?
Bile plays an important role in proper digestion of fat and fat-soluble vitamins. In some people, the liver cannot produce bile or bile does not flow to the gallbladder and duodenum. This happens when you develop a condition called cholestatic liver disease, which is characterized by the degeneration of liver tissue, formation of scar tissue, ...
Why do doctors monitor pregnancy?
Your doctor will monitor your pregnancy and growth of your baby quite closely because a cholestatic liver disease can cause serious complications for a growing baby. Your doctor may take different measures depending on your condition. For instance:
What is cirrhosis in women?
This refers to the impairment of intrahepatic bile ducts. This rare disease affects 40 out of every 100000 people, and women are at greater risk of developing this disease. Although it is called primary biliary cirrhosis, it is worth pointing out that cirrhosis only occurs in the later stages of the disease.
What is the best treatment for itching in newborns?
Treatments. Your doctor will give prescription medications and suggest other treatment options mainly to soothe intense itching. They may give you medication ursodiol that helps decrease the level of bile in your blood that in turn will relieve itching. It also reduces complications for a developing baby.
Why do people need liver transplants?
Primary biliary cirrhosis is a major reason for liver transplantation. Patients do so well that this is becoming the treatment of choice. As experience, technique, and immunosuppression progressively improve, patients with this disease will come to transplant surgery earlier and earlier in their disease course.
How long does cirrhosis last?
As the disease progresses it also scarsthe liver, leading to cirrhosis. In some patients, the disease destroys the liver in as little as five years. In others, it may lie dormant for a decade or more.
What are the symptoms of a bile deficiency?
Ninety percent of patients with this disease are women between the ages of 35 and 60. The first sign of it may be an abnormal blood test on routine examination. Itching is a common early symptom, caused by a buildup of bile in the skin. Fatigue is also common in the early stages of the disease. Later symptoms include jaundice from the accumulation of bile and specific nutritional deficiencies-bruising from vitamin K deficiency, bone pain from vitamin D deficiency, night blindness from vitamin A deficiency, and skin rashes, possibly from vitamin E or essential fatty acid deficiency. All these vitamin problems are related to the absence of bile to assist in the absorption of nutrients from the intestines.
What causes ascites in the stomach?
Continued fluid and electrolyte imbalances and inefficient metabolism of nutrients produce ascites, hypoglycemia, and hypoproteinemia. Obstruction to the return of blood from the portal system causes increased pressure within the veins of the esophagus and stomach. These engorged vessels are subject to rupture with subsequent hemorrhage that is abetted by clotting disorders. jaundicedevelops as a result of biliary obstruction.
What causes a coma in the hepatic system?
Hepatic encephalopathyand coma can be precipitated by any of a number of factors, including gastrointestinal bleeding, fluid and electrolyte and acid-base imbalances, intercurrent infection and fever, administration of analgesics and sedatives that are central nervous system depressants, and increased dietary protein intake.
What is the term for a surgical removal of tissue for examination?
Biopsy— Surgical removal of tissue for examination.
How to treat portal hypertension?
Relief of portal hypertension sometimes is accomplished by a surgical procedure called a portacaval shunt. The portal vein is surgically connected to the inferior vena cava to allow drainage of excessive amounts of blood from the portal system to the general circulation. A similar procedure called the splenorenal shunt involves connecting the splenic vein to the renal vein.
What is the cause of cholestatic bile?
A “cholestatic” situation results when something interferes with the movement of bile from the liver to the gallbladder or from the gallbladder to the small intestine. The most common cause is a gallstone that obstructs the common bile duct. Other physical forms of obstruction occur as well, such as when a tumor compresses the common bile duct.
Why does bilirubin go up?
Bilirubin levels also go up. Bilirubin is the substance that causes jaundice, or the yellow-orange color of someone with a serious liver problem. If you put these two terms together, it’s easy to see that “cholestatic hepatitis” is any form of liver disease that causes inflammation of the liver and a problem with bile transport.
What is hepatitis caused by?
Hepatitis is a term that refers to a condition that causes inflammation of liver cells. We usually think of hepatitis as an infectious condition caused by viruses such as hepatitis A, B or C.
Where is bile made?
Bile is a substance made by the liver that collects in the gallbladder. When a person eats, the gallbladder squeezes the bile out the common bile duct and into the intestine, where it aids in the digestion of food, especially fats.
What is NAFLD in medical terms?
Nonalcoholic fatty liver disease (NAFLD) is the build-up of fat in liver cells. NAFLD can cause the. ... More Answers. Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view.
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Causes and risk factors
Is obstetric cholestasis dangerous?
- Cholestasis is a liver disease. It occurs when the flow of bile from your liver is reduced or blocke…
There are two types of cholestasis: intrahepatic cholestasis and extrahepatic cholestasis. Intrahepatic cholestasis originates within the liver. It can be caused by: - hormonal effects on bile flow
Pregnancy can also increase your risk for this condition.