Cholestasis

CHOLESTASIS

Cholestasis is a condition where bile can’t flow from the liver to the duodenum. Bile formation is a secretary function of the liver. It begins in bile Canaliculi that form between two adjacent surfaces of liver cells similar to the terminal branches of a tree. The Canaliculi join each other to form larger structures, sometimes referred to as canals of hering, which themselves join to form small bile ductules that have an epithelial surface. The ductules join to form bile ducts that eventually form either the right main hepatic duct that drains the right lobe of the liver and the left main hepatic duct draining the left lobe of the liver. The two ducts join to form the common hepatic duct, which in turn joins the cystic duct from the gall bladder, to give the common bile duct. This duct then enters the duodenum at the ampulla of Vater.       

Causes: - The causes of cholestasis are divided into two groups:

i.)                Those originating within the liver and

ii.)              Those originating outside the liver. 

Within The Liver: - Causes include:

i.)         Acute Hepatitis,

ii.)       Alcoholic Liver Disease,

iii.)      Primary biliary Cirrhosis with inflammation and scarring of the         

            bile ducts,                  

iv.)      Cirrhosis due to viral hepatitis B or C,

v.)       Drugs,

vi.)      Hormonal effects on bile flow during Pregnancy and

vii.)     Cancer that has spread to the liver.

Outside The Liver: - Causes include:

i.)                A stone in a bile duct, narrowing of a bile duct,

ii.)              Cancer of a bile duct,

iii.)           Cancer of the Pancreas and

iv.)            Inflammation of the Pancreas.

Symptoms: -

i.)                Jaundice, dark urine, light colored stools and generalized itchiness are characteristic Symptoms of Cholestasis.

ii.)              Jaundice results from excess bilirubin deposited in the skin, and dark urine results from excess bilirubin excreted by the kidneys.

iii.)           Retention of bile products in the skin may cause itching, with subsequent scratching and skin damage.

iv.)            Stools may become light-colored because the passage of bilirubin into the intestine in blocked.

v.)              Stools may contain too much fat because bile can’t enter the intestine to help digest fat in foods.

vi.)            Fatty stools may be foul-smelling. The lack of bile in the intestine also means that calcium and vitamin D are poorly absorbed. If Cholestasis Persists, a deficiency of these nutrients can cause loss of bone tissue. Vitamin K, which is needed for blood clotting, is also poorly absorbed from the intestine, causing a tendency to bleed easily.

vii.)         Prolonged jaundice due to cholestasis produces a muddy skin color and fatty yellow deposits in the skin. Whether the person has other symptoms, such as abdominal pain, loss of appetite, vomiting or fever depends on the cause of cholestasis.

Diagnosis

A doctor tries to determine whether the cause is within or outside the liver on the basis of symptoms and the results of a physical examination. Recent use of drugs that can cause cholestasis suggests a cause within the liver. Small spiders like blood vessels visible in the skin, an enlarged spleen and fluid in the abdominal cavity, which are signs of chronic liver diseases also suggest a cause within the liver.

Findings that suggest a cause outside the liver include certain kinds of abdominal pain and an enlarged gall bladder.

Laboratory Test: - The blood levels of two enzymes alkaline phosphatare and gammaglutamyl transpeptidase are very high in people with cholestasis.

Treatment

Homeopathic Medicine: - Berberis V., Carduus Mar, Chelidonium, China, Hydrastis, Lachesis, Leptandra, Lycopodium, Merc. Sol., Myrica, etc.