cholestatische

Cholestatische is a Dutch term used to describe processes or disorders related to cholestasis, the impairment or stoppage of bile flow from the liver. In English, the corresponding adjective is cholestatic, and cholestasis refers to the condition of reduced bile formation or drainage. Cholestasis can be intrahepatic, due to liver cell or canalicular dysfunction, or extrahepatic, due to obstruction of the bile ducts outside the liver.

Causes of cholestasis include drug-induced liver injury, viral or autoimmune liver diseases, and pregnancy-related intrahepatic cholestasis; extrahepatic causes include gallstones, tumors, and strictures that block the bile ducts. Intrahepatic cholestasis often involves cholestatic injury patterns, whereas extrahepatic cholestasis results from mechanical obstruction.

Clinical features commonly include jaundice, itching (pruritus), dark urine, and pale stools, along with fatigue. Laboratory findings show a cholestatic pattern, typically with elevated alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT), bilirubin elevation, and comparatively modest transaminase elevations.

Diagnosis relies on history, exam, laboratory tests, and imaging. Ultrasound is usually the first step to assess bile ducts; MRCP or ERCP can visualize or address obstructions. Liver biopsy may be used to confirm intrahepatic cholestasis and to differentiate causes such as primary biliary cholangitis or drug-induced cholestasis.

Treatment targets the underlying cause and symptom control. Ursodeoxycholic acid (UDCA) is commonly used in many cholestatic conditions. Itching may be managed with cholestyramine or other agents; fat-soluble vitamins (A, D, E, K) are often supplemented. Avoidance of hepatotoxic drugs is advised, and obstructive cholestasis requires relief of the blockage. Prognosis varies by cause and response to therapy, with some conditions progressing to cirrhosis if untreated.