How is cholestasis diagnosed?
Determining whether obstruction exists inside or outside the liver is the essential part of diagnosis. A history of hepatitis or heavy drinking, recent use of certain drugs, and symptoms like ascites (abnormal abdominal swelling) and splenomegaly (enlarged spleen) suggest intrahepatic cholestasis. Pain or rigidity in the gallbladder or pancreas suggest an extrahepatic
form.
Blood tests and liver function tests can reveal the pattern and extent of liver injury, indicate functional abnormalities, and establish the cause of the condition. However, most misdiagnoses occur when physicians rely more on laboratory analysis than on detailed medical history and the results of a thorough physical examination. Special attention should be paid to three liver function tests. Levels of alkaline phosphatase (ALP), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) can indicate whether the patient's condition is caused by an obstructive condition like cholestasis or a disease of the liver cells (hepatocellular disease) like viral hepatitis or cancer. ALP levels more than three times greater than normal indicate cholestasis. High levels of AST and particularly of ALT, which is found predominantly in liver cells, indicate hepatocellular disease.
Once the disease pattern has been established, ultrasound may be performed to determine whether obstruction of the large duct has caused widening of small ducts located close to it. Computed tomography scans (CT) and magnetic resonance imaging (MRI) can provide more detailed information about the source of the obstruction.
A doctor who thinks a physical obstruction is responsible for progressive deterioration of a patient's condition may consider an exploratory surgical procedure (diagnostic laparotomy). Liver biopsy is sometimes performed if imaging tests do not indicate why a duct is enlarged, but results of a single biopsy may not represent the status of the entire organ. |
More information on cholestasis
What's cholestasis? - Cholestasis is a condition caused by rapidly developing or chronic interruption in the excretion of bile. Cholestasis is the obstruction of the flow of bile from the gall bladder.
What causes cholestasis? - Cholestasis is related to a transient injury. Cholestasis can also be the result of liver diseases such as sclerosing cholangitis, biliary atresia, primary biliary cirrhosis, and others.
What're the symptoms of cholestasis? - Symptoms of both intrahepatic and extrahepatic cholestasis include a yellow discoloration of the skin (jaundice), dark urine, and pale stools.
How is cholestasis diagnosed? - A history of hepatitis or heavy drinking, recent use of certain drugs, and symptoms like ascites and splenomegaly suggest intrahepatic cholestasis.
What's the treatment for cholestasis? - The goal of treatment for cholestasis is to eliminate or control the patient's symptoms. Cholestasis often does not respond to medical therapy of any sort.
What is cholestasis of pregnancy? - Cholestasis of pregnancy is a condition in which the normal flow of bile in the gallbladder is affected by the high amounts of pregnancy hormones.
What causes cholestasis of pregnancy? - Pregnancy hormones affect gallbladder function, resulting in slowing or stopping of the flow of bile.
What's the treatment for cholestasis of pregnancy? - The goals of treating cholestasis of pregnancy are to relieve the itching and prevent complications. |
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