Cholestasis is a medical condition where bile is blocked and doesn’t flow like it is supposed to. In a normal working system, bile flows from the liver into the duodenum. This allows the body to be free of toxins and other gross things, but when the area is blocked Cholestasis occurs. One type of Cholestasis is where the duct is primarily blocked off. The other type is a metabolic condition and works differently than a blockage.
Causes of Cholestasis
Cholestasis can be caused by a number of medical conditions that are pre-existing. In fact, cholestasis is rarely a primary condition. Other diseases often trigger it to occur, thus making it a secondary disease. The medical conditions that cause Cholestasis are usually quite severe and painful.
• ABCC2 Gene polymorphism
• Primary Biliary Cirrhosis
• Inflammatory Bowel Disease
• Certain medications
• Abdominal cancer
• Pediatric liver conditions
• And many others.
Clearly the causes can be quite severe and lead to serious problems for those that develop it. Luckily there is a number of ways to treat this problem so the individual can become healthy again.
Cholestasis of Pregnancy is also another classification of the condition. It is separate from the other types of Cholestasis and it is also treated differently. Many women experience this just a few months before delivery. It fixes itself after delivering the baby, usually within a week. If the cholestasis does not disappear after pregnancy then further treatment is recommended to prevent any problems or serious complications. Generally women with Cholestasis from pregnancy experience itching and discomfort. They may also need special I.V’s to deliver nutrients to the developing baby.
Characteristics of Cholestasis
Underneath a microscope this condition looks quite different. The cells responsible for metabolizing the fats and proteins that goes into the liver will look green and brown. The cells will resemble a nasty infection with a spotted appearance. If the condition is severe the cells will start to rot. On the outside surface cholestasis doesn’t look like anything. Internally the organs may be swollen, tender, and slightly abnormal looking. Ultrasounds and x-rays can determine if the person has an obstruction.
Symptoms of Cholestasis
Since Cholestasis is usually caused by other medical conditions, it is particularly difficult to pinpoint the exact symptoms caused by it. Clay colored and white stool are a common symptom. White stool is actually very rare and usually means something is seriously wrong inside the body. Dark urine despite plenty of liquids is also a symptom. Not being able to stomach foods and regular itching are also serious symptoms. Pain and nausea and vomiting are common, and frequent. Jaundice is also a symptom that develops when the bile is not allowed to freely remove itself from the body. For individuals that have Cholestasis, their stool is pungent smelling. Usually those with a blockage will lose a lot of fat and nutrients through the urine and stool. They will lack calcium as well as Vitamin D. Nutrient deficiencies can cause other problems within the body, such as bone weakness.
If women have cholestasis during pregnancy, early treatment is needed. This will ensure that the baby is delivered safely.
The symptoms may become life altering, and require a lot of down time to prevent them from worsening. Diarrhea and stomach pains may become severe enough to limit a persons normal activity.
Cholestasis can occur either inside the liver or on the outside. Symptom checking and a physical exam will determine which kind of Cholestasis the individual has. After that is completed the doctor will ask quite a few questions regarding drug use, medications taken, and even family history. If recent drug use has been reported then that is likely the cause of Cholestasis. Abdominal pain and an enlarged gallbladder are also major signals that the doctor receives that will point to Cholestasis. Imaging and special scans and testing is done to determine an accurate diagnosis.
Stool testing and urine testing are also good methods to determine if the patient has a blockage. These are done by examining the proteins and nutrients that have been excreted. If there are high protein numbers in the stool, then the person may have a problem with Cholestasis that must be dealt with as soon as possible to prevent damages to the body.
Other enzyme testing can be performed to determine if the patient has Cholestasis, and why they may have developed it. Enzyme testing can be done in several ways by introducing several known reactants with the enzymes that are produced during Cholestasis and several different but closely related medical conditions. It is important that the problem is determined by weeding out everything that it could not be and performing enzyme testing that will narrow it down to being only Cholestasis. This may take some time to determine especially if there are other existing conditions that must be handled as well.
Treatment for this condition is quite tricky. There are a number of methods that doctors can take to treat the condition and help the individual return to a normal life. Surgery is usually the first course of action. Endoscopy is also an option, if the patient wants to avoid scarring. Since cholestasis is usually caused by a number of different conditions, the doctor treating the patient can go a number of routes to secure a safe recovery.
Since medication may also cause Cholestasis, a doctor may decide that stopping the medication is the best course of action. There are a number of back up medications that can be prescribed if the drug is needed by the individual. Stopping medication is a touchy subject, because it can cause violent withdrawals and a more severe condition.
When undergoing treatment for Cholestasis the patient must stop alcohol consumption and medications must be ceased to ensure safe recovery. These are often toxic to the liver and quite harmful in the long run. Those patients that do not stop their alcohol consumption and medications will progressively become worse over time. Secondary complications, infection and other maladies may also occur with improper management of their disease. Taking advantage of the information given by doctors or medical staff can help save the patient’s life and allow them to add years to their lives by treating the disease before it gets too bad and possibly uncontrollable.
Obviously no one can prevent all of the conditions that may cause Cholestasis. Since a number of cases where this occurs include individuals that use drugs, avoiding needle sharing and drug use can prevent this condition. Also avoiding excessive alcohol consumption, and being vaccinated for Hepatitis A and B. All of this can help provide a healthy liver which will not back up their bile which could eventually develop into Choleostasis after some time.
Prognosis for Cholestasis
Most individuals that undergo treatment early on will recover normally. Not seeking treatment early enough can cause severe metabolic problems. It can also cause gallstones to develop, and extreme jaundice may also occur. Sometimes cancer can develop. Most people avoid all of the complications by getting treatment early on and ceasing use of harmful medications and drugs.