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Cholestasis is a condition where bile cannot flow from the gallbladder to the small intestine. It can be caused by physical obstructions, genetic defects, hormonal changes, or pregnancy. Symptoms include dark urine, yellowing of the eyes and skin, and itching. Treatment depends on the cause and can include antibiotics, surgery, or stents. Vaccinations for hepatitis A and B can help prevent the condition.
Cholestasis is a medical condition in which bile cannot flow from the gallbladder into the small intestine. There are a couple of different causes for this type of problem, but the “cholestasis” label applies to all of them; in general it is used to describe an outcome, namely blocked bile, rather than the actual cause. Physical obstacles are one of the easiest to understand. When there are masses, tumors or other growths in the liver or small intestine, the passage of bile can be blocked and it can start to stagnate. There are also a variety of chemical reasons why bile does not pass as it should, including genetic defects and severe hormonal changes. Pregnant women are often particularly at risk for the latter. In most cases the symptoms are the same, regardless of the cause, and include darkening of the urine, yellowing of the eyes and skin, and intense itching, particularly in the hands and feet. The condition is almost always readily treatable, but prompt medical attention is usually very important to avoid serious health consequences.
Role of bile in general
Bile is an important part of human digestion. It is a thick, sticky substance produced by the liver and its main job is to help the small intestine break down complex fats that are taken in through food. Breaking them down not only makes them easier to digest, but also easier to convert into energy quickly. In most cases, the liver produces bile in advance, which it stores in the gallbladder. When the digestive system needs it, it flows into the small intestine and starts working, at which point the liver typically starts generating more.
Cholestasis occurs when the passage from the gallbladder to the intestines is impeded in some way, which leads to a backup and overflow. The blockage is likely to cause an abnormal buildup of lipids and bile salts in the bloodstream, as they cannot be removed from the body. Its possible complications include weakening of the bones, diarrhea and organ failure.
Physical obstructions Physical
When the condition is labeled ‘intrahepatic’ it means that there is an obstruction in the flow of bile occurring within the liver. This is often the most common form and is characterized by medical conditions such as hepatitis or extensive blockage of the small ducts. An extrahepatic condition, on the other hand, is a blockage outside the liver. These can occur as a complication of surgery, due to an infection that destroys tissue, or as a result of a serious injury. It can also be caused by tumors or stones in the bile duct.
Genetic and hormonal problems
People can also sometimes experience bile backups due to chemical imbalances in the body that cause the bile ducts to narrow, narrow, or collapse. These types of problems are often the result of a genetic abnormality or a congenital liver problem. Liver disease often includes bile blockage and duct collapse as symptoms, for example. Sometimes hormonal changes can also be the cause, although in these cases the problem is often more temporary; as soon as the hormones stabilize, the problem tends to disappear. In situations of genetic anomaly the problem tends to be more or less permanent.
Special concerns in pregnancy
Pregnancy increases the sensitivity of the bile ducts to estrogen, which can cause a special type of condition known as “cholestasis of pregnancy.” It most commonly develops during the second or third semester of pregnancy and often causes intense itching. Treatment usually involves regular fetal monitoring and the use of topical antipruritic medications. A woman can also get the disease while using birth control pills with high hormone concentrations. In most cases things will normalize once hormone levels return to normal, either due to birth or stopping pills.
Diagnosis and treatment
Diagnosis usually begins with an assessment of the patient’s outward symptoms. From there, medical professionals and health care providers usually order blood tests and diagnostic imaging such as computed tomography (CT), magnetic resonance imaging (MRI), or ultrasound of the abdomen to confirm whether or not bile is flowing properly.
Treatment typically depends on the cause. Infections are usually treated with antibiotics, while stones, tumors, or other growths are more likely to be addressed through surgery or other more invasive procedures. Sometimes stents are also inserted into the narrowed or blocked portion of the bile duct to restore the flow of bile.
This condition can usually be prevented. Vaccinations for hepatitis A and hepatitis B are usually a good place to start, especially for people at risk of getting the disease. Hepatitis isn’t always linked to bile problems, but the two are often related. Limiting the use of alcohol and harsh medications is also usually recommended, as both can damage the liver over time.
