Cholestatic pruritus

Cholestatic Pruritus

Cholestatic pruritus is a condition where itching is caused by bile salts that are retained in the bloodstream due to liver disease or blocked bile ducts. This itching can be debilitating and can interfere with daily activities. The itching can be localized or widespread, may vary in intensity, and may come and go. The most common symptom of cholestatic pruritus is itching all over the body that is worse in the evening. Other symptoms may include:

• Painful itching on the palms of the hands and soles of the feet
• Itching on the abdomen, chest, back, arms and legs
• Dry or cracked skin
• Thickening of the skin
• Pigment changes in the skin
• Dark urine
• Yellowing of the skin and whites of the eyes (jaundice)

Cholestatic pruritus is more common in adults, although it can affect children. The exact cause of cholestatic pruritus is unknown. It is thought to be related to changes in the level of bile salts, which are formed in the liver and stored in the gallbladder. Bile salts are necessary for normal digestion, and they are excreted in the intestines. If the flow of bile from the liver into the intestines is blocked, the bile salts accumulate in the bloodstream and cause itching.

The diagnosis of cholestatic pruritus is typically made after other causes of itching are ruled out. Treatment may focus on reducing the amount of bile salts in the bloodstream. This may include medications that reduce the production of bile salts or medications that help them be excreted in the stool. Additionally, supportive care such as cool compresses, moisturizers, and anti-itch medications may be used to alleviate symptoms.