Intrahepatic Cholestasis: A Review

Intrahepatic cholestasis is a liver disorder characterized by impaired bile flow within the liver. This condition affects both men and women, although women, particularly pregnant women, are more susceptible to developing it. In this article, we will review the causes, symptoms, diagnosis, and treatment options for intrahepatic cholestasis.

The liver plays a crucial role in producing and releasing bile, which aids in the digestion and absorption of fats. In individuals with intrahepatic cholestasis, the flow of bile within the liver is obstructed, leading to an accumulation of bile acids in the liver and bloodstream. This buildup of bile acids can cause various symptoms and complications.

The exact cause of intrahepatic cholestasis is not fully understood; however, hormonal changes, genetic predisposition, and environmental factors are believed to play a role. Pregnancy-related hormones, such as estrogen and progesterone, have been linked to an increased risk of developing this condition. Certain genetic mutations, such as MDR3 gene mutations, can also contribute to the development of intrahepatic cholestasis.

The most common symptom of intrahepatic cholestasis is pruritus, also known as severe itching. This itching typically occurs on the palms of the hands and soles of the feet but may also affect other areas of the body. Other symptoms can include dark urine, pale stools, jaundice (yellowing of the skin and eyes), fatigue, and abdominal pain. If left untreated, intrahepatic cholestasis can lead to complications such as liver damage and malabsorption of nutrients.

To diagnose intrahepatic cholestasis, a healthcare provider will conduct a thorough medical history review and physical examination. Blood tests may be ordered to assess liver function and detect elevated levels of bile acids or liver enzymes. Imaging techniques like ultrasound or MRI may be used to evaluate the liver and rule out other potential causes of symptoms.

Once diagnosed, the treatment for intrahepatic cholestasis aims to relieve symptoms, manage complications, and prevent further liver damage. Medications like ursodeoxycholic acid (UDCA) may be prescribed to improve bile flow and reduce itchiness. Vitamin K supplements can help manage any bleeding disorders due to impaired fat absorption. Additionally, lifestyle modifications such as dietary changes, including a low-fat diet, and avoiding certain medications known to worsen liver function may be recommended.

Pregnant women with intrahepatic cholestasis require close monitoring to ensure the well-being of both the mother and the baby. Early delivery may be considered in severe cases to prevent potential fetal complications. Regular prenatal check-ups and fetal monitoring are essential to monitor the baby’s growth and well-being.

In conclusion, intrahepatic cholestasis is a liver disorder characterized by impaired bile flow within the liver. It predominantly affects women, especially during pregnancy. The exact cause is not fully understood, but hormonal changes and genetic predisposition are believed to play a role. Prompt diagnosis and appropriate management are vital to alleviate symptoms, prevent complications, and protect liver health. If you experience persistent itching, dark urine, or any other symptoms associated with intrahepatic cholestasis, it is crucial to consult a healthcare professional for an accurate diagnosis and appropriate treatment.