Cholestasis is a condition that is associated with halt or reduce the flow of bile. Among the leading causes are liver disease, biliary tract or pancreatic cancer.
With the stagnation of flow of bile (digestive fluid produced in the liver) we are dealing when liver cells responsible for the production of bile and transporting it to the duodenum, are weakening. When the bile flow is stopped, bilirubin (by-product, which is formed due to damage to red blood cells) enters the bloodstream and accumulate in the liver.
Typically, bilirubin is associated with bile in the liver, and then passes through the bile duct to the digestive tract and is excreted from the body. Most of the bilirubin is excreted in the faeces, a small part also in urine.
The causes of cholestasis
Cholestasis can have various causes, depending on whether they are related to liver problems or those from outside.
The causes of cholestasis resulting from the intrahepatic problems are:
- acute hepatitis,
- alcoholic liver disease,
- primary biliary liver cirrhosis,
- cirrhosis of the liver caused by hepatitis B or C,
- hormonal problems related to for example flow of bile during pregnancy,
- tumour, when spread in the liver.
- the stones in the bile duct,
- narrowing of the bile duct,
- cancer of the bile duct,
- pancreatic cancer,
- inflammation of the pancreas.
The symptoms of cholestasis
The main symptoms that indicate the emergence of cholestasis is:
- a dark shade of urine,
- a light shade of stool
- unpleasant itching all over the body.
The excess of the bilirubin is deposited in the skin and is excreted in increased amounts in the urine. Itching of the skin also occurs due to the accumulation of bile products in the skin. Light shade stool, is caused by stopping the flow of the bilirubin in the gut, which prevents its excretion. Stool with cholestasis may contain a lot of fat, because due to the absence of bile in the gastrointestinal tract, it is not properly destroyed by what is extremely foul-smelling.
Lack of bile in the intestine also means a poor absorption of calcium and vitamin D. If cholestasis persists, a deficiency of these nutrients can lead to bone loss. In addition to the above also vitamin K is poorly absorbed by blocking the bile, which increases the tendency to bleeding episodes and blood clotting problems.
Long-term jaundice caused by cholestasis produces a muddy skin color and yellow fatty deposits in the skin. Sick people, often also complain of abdominal pain, loss of appetite, vomiting or fever.
Diagnosis and treatment of cholestasis
Diagnosis is based on medical assessment, making the blood tests and ultrasound. Sometimes it becomes necessary a liver biopsy. The doctor is trying to determine whether the cause of cholestasis are problems of intrahepatic or extrahepatic.
Treatment of cholestasis is related directly to its causes. Cholestasis is caused by blockage of bile ducts, can be treated by with surgery or endoscopy. Blockade of bile in the liver can be dealt with by using medications and supplements, often, however, the problem disappears arbitrarily.
Sick people should avoid substances that can be toxic to the liver as alcohol or certain medicines. It is also used cholestyramine an oral drug assisting treatment of itching of the skin because it binds with certain bile products in the intestine, which are responsible for skin irritation.
In the treatment of cholestasis it is also necessary vitamin K supplementation to strengthen clotting, and the addition of calcium and vitamin D, in cases where the disease persists a long time – it helps prevent the loss of bone.