Cholestasis refers to any condition that affects the flow of bile from the liver.    

Bile is an important part of the body’s digestive process, as it breaks down fats and allows them to be absorbed by the body. Cholestasis occurs when the flow of bile from the liver is reduced or blocked, or the liver has a problem producing bile.

Types and Causes of Cholestasis

There are several types of cholestasis, and they can be separated into the intrahepatic and extrahepatic categories.

Intrahepatic cholestasis is related to liver disease, which can be brought on by alcoholic liver disease, lymphoma, tuberculosis and viral hepatitis, among other issues. Intrahepatic cholestasis can also occur late in pregnancy, potentially causing severe complications for the baby.

Extrahepatic cholestasis results from a condition outside the liver and can be caused by:

  • Tumors in or near the bile ducts
  • Cysts
  • An inflamed pancreas
  • Gallstones in a bile duct

Symptoms of Cholestasis

The symptoms of intrahepatic and extrahepatic cholestasis are similar and include:

  • Jaundice (yellowing of the skin and eyes)
  • Itchy skin
  • Dark urine
  • Light-colored stool
  • Abdominal pain
  • Fatigue
  • Nausea
  • Poor digestion
  • Vomiting

Diagnosing Cholestasis

When an individual is showing symptoms of cholestasis, the diagnostic process will include a review of the patient’s symptoms and medical history and a physical exam. Blood tests may be ordered to test liver enzymes for signs of cholestasis. Additional tests, such as an ultrasound, MRI or liver biopsy, may be needed to confirm the diagnosis.

Treatments for Cholestasis

The treatment strategy for cholestasis varies depending on the underlying cause of the condition. In some cases, the blocked duct can be opened using stents, and in other cases, stones obstructing the bile duct can be removed. Some patients undergo a partial external biliary diversion surgery, which uses a portion of the intestine to bypass the obstruction.

Because many cholestasis cases eventually involve cirrhosis (scarring) of the liver that prevents the organ from functioning properly, a liver transplant may become an option. Tampa General Hospital’s liver transplant program thoroughly evaluates adult patients with severe cirrhosis, whether it is caused by cholestatic diseases or other factors.