Cholestasis – Types, Symptoms and Treatment

The liver is a large glandular organ in the body. It is responsible for carrying out the major digestive functions in the body. It converts food into energy and removes the toxins from the body. It produces a yellowish green liquid called bile which helps in breaking down food, especially fat.


is essentially a liver condition in which the bile is restricted to flow from the liver to the duodenum. The retention of bile in the liver can cause the onset of auto digestion or necrosis in the cells of the liver. It is a condition which can lead to acute liver failure. One out of 10 Americans is affected by some form of liver disease.

Micrograph showing Cholestasis

Types of Liver Cholestasis

The condition generally manifests itself in two ways:

1. Obstructive

: A mechanical blockage in the bile duct which can inhibit the flow of bile.
Some conditions which can cause a mechanical blockage are as follows:

  • Bile Duct Tumors.
  • Cysts.
  • Abnormal narrowing or stricture of the bile ducts.
  • Gall stones in the common bile duct.
  • Pancreatitis.
  • Pancreatic pseudocyst or tumor.
  • Pressure exerted on the bile duct by nearby mass of tissue.
  • Ascending Cholangitis (inflammation and infection in the bile ducts).

2. Hepatocellular

: Any intrinsic condition at the cellular level in the liver can restrict the flow of bile. Some conditions which can cause the hepatocellular variety are as follows:

  • Chronic alcohol abuse.
  • Pregnancy.
  • Lymphoma.
  • Neoplasms or cancers in the liver.
  • Bacterial abscess.
  • Viral hepatitis.
  • Amyloidosis.
  • Sepsis or the spreading of infection through the blood stream.
  • Cholangitis.
  • Hypertoxicity or drug induced liver damage. Drugs like acetaminophen, flucloxacillin, erthromycin, aspirin, ibuprofen etc can induce damage.

Symptoms of the condition

  • Itchy skin or pruritas. It is the primary symptom of the condition. The serum bile acids irritate the nerve endings (opioidergic nerves) and cause the skin reactions.
  • Jaundice or yellowing of skin. Mostly seen in the ostructive type of the condition.
  • Pale or clay colored stool is mostly seen in the obstructive type of the disease.
  • Dark urine.

Treatment of Liver Cholestasis

Treatment of the condition generally involves treating the underlying cause of the blockage, be it a mechanical blockage or a cellular deformity.

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