Cholestasis Overview: Symptoms, Causes, and Treatment
Cholestasis is a condition that impairs bile flow from the liver. Learn about its symptoms, causes (including pregnancy), diagnosis, and the various treatment options available.
Written by Dr. M L Ezhilarasan
Reviewed by Dr. D Bhanu Prakash MBBS, AFIH, Advanced certificate in critical care medicine, Fellowship in critical care medicine
Last updated on 1st Sep, 2025
Introduction
Cholestasis is a liver condition that affects the flow of bile, a digestive fluid produced by the liver. When bile flow is reduced or blocked, it can lead to a buildup of bile acids in the blood, causing discomfort and potential health complications. While cholestasis can occur in anyone, it is most commonly seen in pregnant women (known as intrahepatic cholestasis of pregnancy or ICP).
Understanding cholestasis, its symptoms, causes, and treatment options can help you manage the condition effectively. Let’s explore this in simple terms.
What Are the Symptoms of Cholestasis?
The most common signs of cholestasis include:
Itching (Pruritus): This is often the first and most noticeable symptom, especially on the palms of the hands and soles of the feet. The itching can become severe, particularly at night.
Jaundice (Yellowing of Skin and Eyes): Due to the buildup of bilirubin (a bile pigment), the skin and whites of the eyes may turn yellow.
Dark Urine: Urine may appear darker than usual.
Pale or ClayColored Stools: Since bile helps in digestion, its reduced flow can make stools lighter in color.
Fatigue and Weakness: The liver’s reduced ability to process toxins can lead to tiredness.
Nausea or Loss of Appetite: Some people may experience digestive discomfort.
If you notice these symptoms, especially persistent itching without a rash, consult a doctor for proper evaluation.
What Causes Cholestasis?
Cholestasis can occur due to problems within the liver (intrahepatic cholestasis) or outside the liver (extrahepatic cholestasis).
Common Causes Include:
1. Pregnancy (ICP): Hormonal changes can slow bile flow, leading to cholestasis, usually in the third trimester.
2. Gallstones or Blocked Bile Ducts: These can physically obstruct bile flow.
3. Liver Diseases: Conditions like hepatitis, cirrhosis, or fatty liver disease can impair bile production.
4. Medications: Certain antibiotics, hormonal treatments, or other drugs may trigger cholestasis.
5. Genetic Factors: Some inherited conditions, like primary biliary cholangitis (PBC), can cause long-term cholestasis.
6. Infections or Tumors: These may block bile ducts or affect liver function.
Identifying the underlying cause is crucial for proper treatment.
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How Does Cholestasis Affect Health?
If left untreated, cholestasis can lead to complications such as:
Malabsorption of Fats and Vitamins: Since bile helps digest fats, its reduced flow can lead to deficiencies in fat-soluble vitamins (A, D, E, K).
Liver Damage: Prolonged bile buildup can harm liver cells, increasing the risk of scarring (fibrosis) or cirrhosis.
Increased Risk of Preterm Birth (in Pregnancy): Pregnant women with cholestasis may need early delivery to prevent risks to the baby.
Early diagnosis and management can help prevent these complications.
How Is Cholestasis Treated?
Treatment depends on the cause and severity of the condition. Common approaches include:
1. Medications
Ursodeoxycholic Acid (UDCA): Helps improve bile flow and reduce itching.
Antihistamines or Topical Creams: May provide temporary relief from itching.
Vitamin Supplements: If deficiencies are detected, supplements (especially vitamin K for clotting) may be prescribed.
2. Lifestyle & Dietary Changes
Stay Hydrated: Drinking plenty of water helps flush toxins.
Avoid Fatty or Spicy Foods: These can worsen symptoms.
Cool Baths & Moisturizers: Can help soothe itchy skin.
Wear Loose, Breathable Clothing: Reduces skin irritation.
3. Medical Procedures
If gallstones or blockages are the cause, procedures like ERCP (Endoscopic Retrograde Cholangiopancreatography) may be needed to remove the blockage.
4. PregnancySpecific Care
Regular monitoring of liver function and fetal health.
Early delivery (around 37 weeks) may be recommended to reduce risks.
When to See a Doctor?
If you experience:
Severe itching without a rash
Yellowing of skin or eyes
Dark urine or pale stools
Persistent nausea or fatigue
Seek medical advice promptly. Early treatment can prevent complications.
Final Thoughts
Cholestasis can be uncomfortable, but with proper care, most people manage it well. If you suspect you have symptoms, don’t ignore them—consult a doctor for a proper diagnosis and treatment plan.
Need Help? If you're experiencing symptoms or need expert advice, you can book a consultation with a liver specialist through Apollo 24|7. Early detection and care make a big difference!
Stay informed, stay healthy!
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