Liver cholestasis causes, symptoms, diagnosis, treatment & pathology

[@nigelnyoni8265]

Bile usually flows from liver into small intestine for fat absorption. When bile isn't flowing, we call it Cholestasis (bile, inactivity) There are 2 types of Cholestasis: Hepatocellular cholestasis (hepatocytes not making enough bile) Obstructive Cholestasis (physical barrier preventing bile secretion) Hepatocellular cholestasis is intrahepatic. Estrogen inhibits export pump that moves bile to canaliculi (to bile ductules to Common Hepatic duct) So hepatocytes can't pump out cholic acid. . Prod and secretion of bile acids is a driving force for bile acid synthesis. Failure to transport signals down regulation of synthesis and secretion. When conjugated bilirubin is building up together with bile acids, they diffuse/are exocytosed into interstitial space and blood supply. Hepatocellular cholestasis is seen in situations where estrogen levels might be higher. Oral contraceptives have been linked to developing cholestasis. Pregnancy induced cholestasis results from rising estrogen levels in mother (it isn't dangerous to fetus or mum) Anabolic steroids have also been linked to cholestasis. They're similar in structure to estrogen. Neonatal hepatitis: bile producing mechanisms are immature in newborns, hence decreased bile prod ability. Developing livers are sensitive to injury in newborns. .... Obstructive cholestasis is extrahepatic. Common bile duct is often physically blocked (e.g. by gallstones from gall bladder, or primary sclerosing cholangitis where immune system attacks bile ducts causing inflammation and scar tissue in ducts and making bile flow difficult) Biliary atresia specifically affects newborns and is like sclerosing cholangitis. It results from immune attacks. Pancreatic carcinomas growing out of the head of the pancreas can physically block bile flow as common bile duct moves through pancreas head. . Histologically, bile build-up displays as bile lakes/bile infarcts (yellowish green bile in interstitial space). . Clinical findings for obstructive Cholestasis are jaundice and pruritus. Bile accumulates in liver and seeps into serum. Bile duct obstruction pressure increases in ducts causing bile to leak between tight junctions of hepatocytes and into interstitial space and then into serum. Conjugated bilirubin can enter blood (hence yellow skin tone) Bile salts will cause pruritis (itchy skin) when they irritate skin upon deposition. Cholesterol can deposit in skin (xanthomas) . Hepatocellular cholestasis involves prod. Of bile salts, and conjugated bilirubin, but not properly excreted, hence they leak out causing pruritis and jaundice. Xanthomas aren't characteristic here as bile doesn't leak through tight junctions here. . Blocked or reduced bile flow => reduced nutrient absorption from small intestine (especially fat solubles as bile emulsifies fats). Usually, Conjugated bilirubin is converted to urobilinogen by gut microbes which gives stool brown colour; when bile flow is blocked, stool has lighter colour. Usually, Some urobilinogen is reabsorbed and excreted in urine. If bile flow is diminished, less urobilinogen is found in urine. Conjugated bilirubin however will be increased in urine (bilirubinuria = darker urine). ALP and GGT will be higher in blood as they're membrane bound enzymes sensitive to hepatocyte damage/stress. .

[@fahdmohammed1042]

Perfect explanation and better then video , thak you ❤

[@liibanmohamud8626]

Thanks for you helping me!

[@chaima184]

You're a hero. Thank you.

[@zachantafrazier852]

38 weeks pregnant and itching everywhere like crazy, because bile is currently in my blood stream.

[@sakurabonita9905]

Thanks a lot for detailed explanation.

[@Firas_87]

A very important correction: Intrahepatic Cholestasis of Preganancy is actually a serious condition and if it goes uncontrolled it could become life-threatening for the fetus. Thanks for the video. Keep it up!

[@ajbetts]

Great information, thanks for the share.

[@akaruitaiyo]

Thank you so so much

[@nessieness5433]

Very interesting, thank you! What are the therapies you talk about at the end of the presentation?

[@tumblrforever681]

Thank you!

[@prajwalareddy2603]

Thank u sir

[@lintahghuman4136]

Thank you

[@reginaphalange4182]

I didn't understand most of this, but that's obviously my own fault. I'm hoping to find a video along the lines of, "Cholestasis for Dummies", 😆. Seriously though, THANK YOU!...I found hundreds of videos when searching "cholestasis" and yours was the only one I saw that wasn't strictly about having it during pregnancy.

[@user-dr8th8jw1q]

shutup

[@dr.anonymoussss152]

Thanks

[@bo_obylady7092]

Urobilinogen is converted to urobilin, which gives urine its yellow color Some of urobilinogen is also also converted to stercobilin, which gives stool its brown color. the video is correct, Im just being frustratingly specific cause my teacher marked me wrong when I answered Urobilinogen to the question "what gives stool its characteristic brown color"

[@khamissalim1200]

U supposed to say bile

[@agglyusr]

Hero

[@Nushka23]

Are there any links to the mini pill (progesterone only) and cholestasis?

[@SuperExadidas]

Thank you...what kind of laboratory test....to confirm if I have Cholestasis.

[@elishasamuel4105]

❤

[@BottomsupET]

What are the treatments

[@mcjs8640]

I have just been told that I have this - caused by the antibiotic Flucloxacillin. I only took it for two days as it made me so ill. Quite shocked.

[@prasantasharma6292]

Can I get your insta id please..

[@erosramasotti1080]

video title said treatment...

[@chelelkorir302]

Hello, I was recently pregnant but sadly lost the pregnancy at 10 weeks, a week before the miscarriage; my skin started itching. It's been three weeks now since the loss but the itching is extreme, no diagnosis yet. What should I do/avoid to minimize the itching? I need help, every part of my body itches, including the palms of my hands.

[@nigelnyoni8265]

Visit a DOCTOR

[@bensonvarghese2154]

Isn't the color of stool given by stercobilinogen?? Urobilinogen provides color to urine only.. I guess so....!

[@KV-nf6sw]

Gut flora converts conjugated bilirubin into urobilinogen . 90% of it gets converted into stercobilinogen that imparts colour to stool and urobilinogen imparts colour to urine. So , u are correct 😌

[@me-ic6rd]

Your way of explaining is very perfect🖤🖤 but put Arabic translation please 🤝

[@kasaromosi]

Is this condition called "BRIC"??

[@hritamsenapati7687]

Bro he just downloaded and uploaded it from osmosis telegram channel , he Doesn't deserve the praises

[@anitasanz2600]

What kinda of Doctor would you see for this?

[@aleksandarkozokic]

probably a gastro-entherologist

[@sydney7355]

Dr. Garrett Smith, the nutrition detective on KZbin specializes in cholestasis

[@nasmaahmed1504]

عع

[@KT-bg7dq]

Dandelion and milk thistle cures it

[@MikeTheTravelBug]

@Andi Miller well what did you end up doing/using?

[@helenalovelock1030]

I have heard that TUDCA can help too