Cholestasis

What is jaundice? — Jaundice is a condition that causes your skin or the whites of your eyes to turn yellow. It happens when you have too much of a substance called "bilirubin" in your blood.
What causes jaundice? — Jaundice is usually caused by problems with your liver, which is a big organ in the upper right side of your belly. It can also be caused by problems with your gallbladder or pancreas (figure 1).
Normally, the liver stores bile, a fluid that helps the body break down fat. When you eat a meal that has fat in it, your gallbladder empties the bile into a tube called the "bile duct." The bile duct carries the bile into the small intestine to help with digestion.
Problems with the liver, gallbladder, or pancreas can be caused by:
Small stones that form inside the gallbladder, called gallstones, which can block the bile duct
Infections
Heavy alcohol use
Damage from medicines, herbal supplements, or illegal drugs
Cancer
You can also get jaundice after surgery, if you have certain blood disorders, or if you have a condition called Gilbert syndrome.
Gilbert syndrome is a common, harmless condition that can run in families. People with this syndrome sometimes get jaundice when they are under stress, take certain medicines, or have an infection. Women with Gilbert syndrome might get jaundice around the time of their period.
Is there a test for jaundice? — Yes. Your doctor will give you a blood test to measure the level of bilirubin in your blood. Your doctor might also give you tests to see what's causing your jaundice.
Will I need tests? — Your doctor or nurse will decide which tests you should have based on your age, other symptoms, and individual situation.
Tests doctors use to find the cause of jaundice might include:
Blood tests
An ultrasound – This test uses sound waves to take pictures of the organs inside your belly.
A CT scan – This is a special kind of X-ray.
An MRCP – This is a special kind of scan that lets your doctor look at your bile duct.
A biopsy – For this test, a doctor takes a small sample of tissue from your liver. Then another doctor will look at the sample under a microscope.
How is jaundice treated? — Treatments depend on what's causing the jaundice. Your doctor or nurse might recommend that you:
Get plenty of rest – Ask your doctor or nurse when it is OK to go back to work or school.
Avoid alcohol
Avoid certain medicines – Your doctor or nurse will talk with you about the medicines you take and tell you which ones to avoid.
If your jaundice was caused by gallstones, you might also need to take medicines or have surgery to remove your gallbladder. Sometimes gallstones in the bile duct can be removed during an ERCP test. For an ERCP, the doctor puts a flexible tube down your throat and takes X-rays to see and remove the gallstone.
If you have Gilbert syndrome, you will not need to do anything extra to treat your jaundice. Gilbert syndrome does not cause long-term problems on its own.
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This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 16983 Version 7.0
Release: 28.2.2 - C28.105
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