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Liver

Obstructive Jaundice (Cholestatic Liver Disease)

This develops when the flow of bile normally excreted by the liver is either reduced or blocked and retained in the bloodstream. There are a number of possible root causes of cholestasis including: gallstones; tumours of the pancreas/bile duct or liver; a reaction to the use of certain therapeutic drugs such as analgesics, anti-bacterials, and non-steroidal anti-inflammatories; hormonal changes brought on by pregnancy; and alcoholic liver disease.

Symptoms

These include jaundice, fatigue and pruritus (itching). Other symptoms can include dark coloured urine and light coloured stools.

Diagnosis

Your doctor will determine the cause of the blockage by reviewing your symptoms and by physical examination. Blood tests and an imaging study are likely to be performed using either ultrasound , CT or MRI technology.

Treatment

Treatment depends on the diagnosed cause or underlying problem, which may be due to problems within the liver or outside it.

A blockage of the bile ducts outside of the liver (known as obstructive or extrahepatic cholestasis) can usually be treated by surgery, whilst a blockage within the liver (known as hepatocellular or intrahepatic cholestasis) may be treated in several different ways depending on the cause. These treatment regimes are focused on dealing with the symptoms (such as itchiness) and advice to patients to stop using substances that are toxic to the liver such as alcohol and certain drugs – there is no effective treatment for intrahepatic cholestasis itself.

Prognosis/outlook

This depends on the underlying problem – for example, cholestasis during pregnancy should resolve itself sometime soon after the baby has been born. If after six months the problems (itching in particular) are on-going, further specialist medical intervention may be needed.

To arrange a consultation with a liver consultant please contact The Princess Grace Hospital, Liver, Bile Duct and Pancreas Unit