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Cholestatic pruritus is the sensation of itch due to nearly any liver disease, but the most commonly associated entities are primary biliary cholangitis, primary sclerosing cholangitis, obstructive choledocholithiasis, carcinoma of the bile duct, cholestasis (also see drug-induced pruritus), and chronic hepatitis C viral infection and other forms of viral hepatitis.
Primary biliary cholangitis (PBC), previously known as primary biliary cirrhosis, is an autoimmune disease of the liver. [1] [2] [3] It results from a slow, progressive destruction of the small bile ducts of the liver, causing bile and other toxins to build up in the liver, a condition called cholestasis.
Liver toxicity, allergic reaction, anaphylaxis [3] Kava: awa, kava-kava [4] Piper methysticum: Potentiates CNS sedatives, [3] chronic use might cause a reversible dry skin condition. [18] Khat: qat Catha edulis: Chronic liver dysfunction [3] [19] Kratom: Mitragyna speciosa: Hepatotoxicity [20] [19] Liquorice root Glycyrrhiza glabra
Abdominal pain and swelling: Liver disease can cause inflammation and swelling in the liver, leading to discomfort or pain in the right upper quadrant of the abdomen.
Affected individuals may have no symptoms or may experience signs and symptoms of liver disease, such as yellow discoloration of the skin and eyes, itching, and abdominal pain. The bile duct scarring that occurs in PSC narrows the ducts of the biliary tree and impedes the flow of bile to the intestines.
These changes facilitate bacteria growth and increase the amount of circulating endotoxin. Moreover, given that patients using TPN often have underlying health problems, drugs being used with known liver toxicity may also cause cholestasis. Lipids in TPN may cause cholestasis and liver damage by overwhelming clearage mechanisms. [58]
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