Navigate Up

Seniors Center - A-Z Index

#
Q
Y
Z

Print This Page

Cholestasis

Cholestasis is any condition in which the flow of bile from the liver is slowed or blocked.

Alternative Names

Intrahepatic cholestasis; Extrahepatic cholestasis

Causes, incidence, and risk factors

There are many causes of cholestasis.

Extrahepatic cholestasis occurs outside the liver. It can be caused by:

  • Bile duct tumors
  • Cysts
  • Narrowing of the bile duct (strictures)
  • Stones in the common bile duct
  • Pancreatitis
  • Pancreatic tumor or pseudocyst
  • Pressure on the bile ducts due to a nearby mass or tumor
  • Primary sclerosing cholangitis

Intrahepatic cholestasis occurs inside the liver. It can be caused by:

  • Alcoholic liver disease
  • Amyloidosis
  • Bacterial abscess in the liver
  • Being fed exclusively through a vein (IV)
  • Lymphoma
  • Pregnancy
  • Primary biliary cirrhosis
  • Primary sclerosing cholangitis
  • Serious infections that have spread through the bloodstream (sepsis)
  • Tuberculosis
  • Viral hepatitis

Certain medications can also cause cholestasis, including:

  • Antibiotics such as ampicillin and other penicillins
  • Anabolic steroids
  • Birth control pills
  • Chlorpromazine
  • Cimetidine
  • Estradiol
  • Imipramine
  • Prochlorperazine
  • Terbinafine
  • Tolbutamide

Symptoms

  • Clay-colored or white stools
  • Dark urine
  • Inability to digest certain foods
  • Itching
  • Nausea or vomiting
  • Pain in the right upper part of the abdomen
  • Yellow skin or eyes

Signs and tests

Blood tests may show that you have too much bilirubin and alkaline phosphatase .

Imaging tests are used to diagnose this condition. Tests include:

  • CT scan of the abdomen
  • MRI of the abdomen
  • Endoscopic retrograde cholangiopancreatography (ERCP) (can also determine cause)
  • Ultrasound of the abdomen

Treatment

The underlying cause of cholestasis must be treated.

Expectations (prognosis)

How well a person does depends on the disease causing the condition. Stones in the common bile duct usually can be removed, curing the cholestasis.

Stents can be placed to open areas of the common bile duct that are narrowed or blocked by cancers.

Complications

  • Diarrhea
  • Organ failure can occur if sepsis develops
  • Poor absorption of fat and fat-soluble vitamins
  • Severe itching
  • Weak bones (osteomalacia) due to having cholestasis for a very long time

Calling your health care provider

Call your health care provider if you have:

  • Persistent itching
  • Yellow skin or eyes
  • Other symptoms of cholestasis

Prevention

Get vaccinated for hepatitis A and B if you are at risk. Avoid intravenous drug use and needle sharing.

References

Zollner G, Trauner M. Mechanisms of cholestasis. Clinics in Liver Disease. 2008;12:1-26.

Afdhal NH. Diseases of the gallbladder and bile ducts. In: Goldman L, Ausiello D, eds. Goldman’s Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 158.

Updated: 5/24/2012

David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc., and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California.


©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com