Cholestasis

Cholestasis

Cholestasis is to reduce or halt the flow of bile. Obstruction of bile flow can lead to various factors.

The flow of bile can be weakened at any point between the liver cells and duodenum (upper small intestine). Even when the bile does not flow, the liver continues to adapt the bilirubin, which escapes into the bloodstream. Then the bilirubin deposited in the skin and comes into the urine, causing jaundice.

For the purpose of diagnosis and treatment of causes of cholestasis are divided into two groups: those originating from the liver and those who cause outside the liver.

Causes within the liver include hepatitis, alcoholic liver disease, primary biliary cirrhosis, the effects of drugs and the effects of hormonal changes during pregnancy (a condition called cholestasis maternity).

Causes outside the liver are gall stones in the water, a narrowing (stricture) duct, common bile duct cancer, pancreatic cancer and pancreatitis.

Symptoms

Jaundice and dark urine originate from the large amounts of bilirubin in the skin and urine. The chair is sometimes pale due to lack of bilirubin in the intestine. Stool may contain too much fat (a condition called steatorrhea) because bile in the intestine there to help digest fat from food.

Lack of bile in the intestine also means that calcium and vitamin D is not absorbed properly. If cholestasis persists, the lack of these nutrients can cause bone loss, which can lead to pain and fractures. Poorly absorbed substances that are necessary for blood clotting, which creates a tendency to bleed easily.

Retention of bile products in the circulation can cause itching (with resultant scratching and skin damage). Due to prolonged cholestatic jaundice created a dirty color and yellow fatty deposits in the skin. The causal agent of cholestasis determines whether people have other symptoms such as abdominal pain, loss of appetite, vomiting or fever.

Diagnosis

To determine whether the cause is within the liver, the doctor examines the symptoms of hepatitis, abundant intake of alcohol or taken drugs shortly that can lead to cholestasis. Small, spider-like blood vessels visible in the skin (called spider nevi), enlarged spleen and free fluid in the abdominal cavity (ascites) means the disease of liver cells.If the cause is outside the liver, the person may have chills, pain from the biliary system or pancreas, and gall bladder increased (the doctor can detect palpable or imaging tests).

For people with cholestasis is typical that their levels of an enzyme called alkaline phosphatase in the blood is very high. Blood test that measures the level of bilirubin indicates the severity of cholestasis, but not its cause.

If the results of blood tests were abnormal, almost always for U.S., CT, or both. This helps the doctor distinguish between liver disease and bile duct closure. If it appears that the cause in the liver, can do a liver biopsy (taking a sample of tissue for microscopic examination). Biopsy usually establishes the diagnosis. If it appears that the cause of the blockage of bile ducts, often this is an endoscopic procedure (using a flexible viewing tube) to clarify the nature of the blockade.

Treatment

The blockade outside the liver can usually be treated with surgery or therapeutic endoscopy (a procedure that involves the use of flexible pipe connections with surgery). Blockage within the liver can be treated in different ways depending on the cause. If the suspected cause of a medication, a person should stop taking it. If the blockade is responsible for hepatitis, then cholestasis and jaundice usually disappear when you stop hepatitis.

For the treatment of pruritus can be taken orally (by mouth) cholestyramine. This drug binds with certain bile products in the intestine, so they can re resorbirati and cause skin irritation.

As long as the liver is severely damaged by vitamin K intake can improve blood clotting. If cholestasis persists, often taking extra calcium and vitamin D, but they are not very effective in preventing bone disease. If too much fat in the stool extract, a person may give further triglycerides.