What is bile stasis
Bile is a fluid produced by the liver. She splits fats into fatty acids so that the body can absorb them through the digestive tract. She also displays unnecessary hemoglobin is removed from the body.
When the flow of bile from the liver to the intestines slows down, stagnation occurs. As a result, bile accumulates in ducts and organs, irritating tissues and disrupting their functioning. And the substances normally excreted with it are saved. This condition is also called cholestasis.
Why is bile stagnation dangerous?
Cholestasis itself does not lead to death. But some of its complications are dangerous. Stagnation of bile may provoke:
- Inflammation of the liver, gallbladder, pancreas, or bile ducts. Over time, this causes scars to form that interfere with the normal functioning of organs.
- Problems breaking down fats, which causes diarrhea and stomach upset. Malabsorption of fat-soluble vitamins E, D, K and A, which can lead to growth retardation and nutritional deficiencies in children.
- Jaundice and severe itching due to the accumulation of bile in the blood.
In pregnant women, untreated cholestasis can become reason preeclampsia, premature birth and stillbirth.
If bile stagnation occurs in a person with sepsis, it may also cause failure organs, such as the liver.
What are the symptoms of bile stagnation?
To the most typical symptoms relate:
- itching, which may feel unbearable and worsen at night;
- jaundice;
- frequent bleeding;
- dark urine;
- stools that are clayey or pale in color;
- pain in the right upper abdomen;
- nausea and vomiting;
- difficulties with digesting certain foods, especially those that contain a lot of fat: pork and beef, salmon, milk.
When to see a doctor
As soon as arise signs of a problem. Particularly indicative will be constant or severe itching – this is a marker symptom by which cholestasis can be suspected.
Why does bile stagnation occur?
There are many causes of cholestasis. Conventionally, they can be divided into two categories.
1. Liver problems
With certain diseases and conditions, the liver’s ability to secrete bile into the ducts is reduced. In this case, they talk about intrahepatic cholestasis. Possible causes:
- alcoholic liver disease,
- bacterial liver abscess,
- intravenous nutrition,
- lymphoma,
- liver cancer,
- sarcoidosis,
- sepsis,
- tuberculosis,
- viral hepatitis,
- taking certain medications (estrogen-progestin contraceptives, anabolic steroids, antibiotics).
2. Problems with the bile ducts
Stagnation can occur when the ducts cannot pass enough bile through them. Causes may be like this:
- stones in the bile duct,
- cysts,
- pancreatitis – inflammation of the pancreas,
- cholangitis,
- bile duct cancer,
- pancreas cancer.
Who is most likely to experience bile stagnation?
Although anyone can experience bile stagnation, there are those who develop it more often.
Pregnant
In pregnant women, cholestasis may arise at the end of the second trimester or in the third, when estrogen levels reach their maximum. This hormone suppresses the secretion of bile in the liver. After the birth of the child, bile stagnation goes away on its own.
Small children
Stagnation of bile can occur in a newborn or a child who is 2–3 months old. In this case They say about neonatal cholestasis. The causes of the disease in children can be differ from those listed above. Their bile stagnates under such circumstances as:
- Bile duct blockagewhich can occur in the womb or in the first few weeks of life.
- Infections: cytomegalovirus, toxoplasmosis, rubella, herpes, syphilis, echovirus, adenovirus and parvovirus, as well as Escherichia coli bacteria.
- Autoimmune liver diseases, which begin even before birth. This happens because the mother’s antibodies penetrate the placenta and attack the baby’s liver.
- Metabolic disorderswhich occur when a newborn lacks the enzyme necessary to break down certain substances.
- Genetic diseases and defectsdisrupting the normal production and excretion of bile.
- Intravenous nutrition in premature newborns or in infants with short bowel syndrome.
- Neonatal hepatitis. In this condition, inflammation occurs in the newborn’s liver, the cause of which has not been established.
How is bile stagnation diagnosed?
The doctor will ask you about all your symptoms and health status. Will appoint research:
- General blood and urine tests will help assess the condition of the body.
- Blood chemistry will show elevated bilirubin levels, characteristic of cholestasis.
- Bile analysis helps determine its composition and density.
- Ultrasound of the liver and bile ducts done to find stones and assess the thickness of bile.
- Coprogram helps check bowel function and digestion quality.
- Computed and magnetic resonance imaging used to determine the cause of bile stagnation.
- Biopsy needed to check for liver cancer in some cases.
How to treat bile stagnation
Cholestasis cannot be cured on its own. Here’s what your doctor can suggest.
Remove symptoms
To eliminate itching, a specialist may prescribe a remedy based on cholestyramine. When prescribing, it will be important for the doctor to take into account all the medications the patient is already using, because this medicine may interact with them. Be sure to tell your doctor if accept contraceptives and diuretics, digoxin, penicillin G, phenobarbital, phenylbutazone, propranolol, spironolactone, tetracycline, levothyroxine or warfarin.
Pregnant women usually offer:
- Preparations with ursodeoxycholic acid, hydroxyzine, dexamethasone.
- Calamine lotion or water cream with 2% menthol.
- Bathing in a warm bath.
- Early birth in some cases.
Eliminate acute cholestasis
To get rid of cholestasis, you must first remove its cause. If congestion has appeared recently, the doctor may recommend:
- antibiotics or antiviral drugs to treat infections;
- changing medications if cholestasis is caused by taking medications;
- an endoscopic procedure to clear blocked ducts and insert stents to widen them.
If cholestasis is due to vitamin K deficiency, a specialist may appoint supplements to replenish its required volume.
Combat chronic bile stagnation
Causes associated with chronic liver disease are more difficult to treat. Here’s what they usually are appointments doctor:
- Adjusting your diet. Choosing certain foods and taking vitamins can help compensate for poor absorption and nutrient deficiencies.
- Lifestyle changes: Exercise and avoiding alcohol will help slow down the progression of diseases. This will make it possible to focus on eliminating the side effects of the underlying disease.
- Products containing ursodeoxycholic acid usually used to dissolve gallstones. Drugs help improve the liver’s ability to function and reduce the level of bile in the blood.
- Naltrexone Prescribed when the itching is very severe and other remedies do not help. The remedy works by blocking pathways to nerves that are irritated by bile acids in the blood. This drug can only be taken in precisely calculated dosages and under the supervision of a physician.
- Cholestyramine. In addition to relieving itching, this medicine allows more cholesterol to be excreted in feces and less of it to be absorbed into the blood.
How to prevent bile stagnation in the liver
Cholestasis cannot always be prevented. But there are things that are worth do to prevent the most common causes of the disease:
- Get vaccinated against hepatitis A A and B.
- Avoid alcohol and drugs, especially intravenous drugs.
- Avoid diets that are high in fat, cholesterol, and low in fiber, as well as diets designed to quickly lose weight. This is especially important if you have previously been diagnosed with gallstones.
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