A blockage of the bile ducts can usually be treated with surgery or endoscopy (using a flexible viewing tube with surgical instruments attached). A blockage within the liver may be treated in various ways depending on the cause. If a drug is the suspected cause, the doctor stops its use. If acute hepatitis is the cause, cholestasis and jaundice usually disappear when hepatitis has run its course. A person with cholestasis is advised to avoid or stop using any substance that is toxic to the liver, such as alcohol and certain drugs.
Diagnosis of Cholestasis
Typically, the blood levels of two enzymes, alkaline phosphatase and gamma-glutamyl transpeptidase, are very high in people with cholestasis. A blood test that measures the level of bilirubin indicates the severity of the cholestasis but not its cause. An imaging study, usually ultrasonography, is almost always done if blood test results are abnormal. Computed tomography (CT) or sometimes magnetic resonance imaging (MRI) may be done in addition to or instead of ultrasonography. If the cause appears to be within the liver, a liver biopsy (see Diagnostic Tests for Liver, Gallbladder, and Biliary Disorders: Biopsy of the Liver) may be done and usually establishes the diagnosis.
Cholestyramine, taken by mouth, can be used to treat itchiness. This drug binds with certain bile products in the intestine, so they cannot be reabsorbed to irritate the skin. Unless the liver is severely damaged, taking vitamin K can improve blood clotting. Supplements of calcium and vitamin D (Ergocalciferol) are often taken if the cholestasis persists, but they are not very effective in preventing loss of bone tissue.
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