Cholestasis is a condition that causes the normal flow of bile to be slowed or stopped. “Chole” refers to bile and “stasis” means “not moving.” Bile flow may be blocked inside the liver, outside the liver or in both places.

If bile does not flow properly, food will not be digested and failure to thrive will become evident. The liver may also be damaged from excess bile in the liver, causing cirrhosis.

What causes cholestasis?

Some causes of cholestasis include the following:

  • Biliary atresia (missing gallbladder)
  • Sepsis (blood infection)
  • Hypothyroidism
  • Galactosemia
  • Hepatitis
  • Drug effects
  • A stone in the bile duct
  • Bile duct narrowing
  • Bile duct cancer
  • Pancreatic cancer (very rare in children)
  • Inflammation of the pancreas.

A liver biopsy may be needed to evaluate the different causes of cholestasis.

What are the symptoms of cholestasis?

Symptoms of cholestasis of may be different for each person. The most common symptoms are:

  • Overall itching, especially the palms of the hands and soles of the feet
  • Mild nausea and pain in the upper right part of the belly
  • Dark urine color
  • Light coloring of stools (bowel movements)
  • Easy bleeding
  • Chills
  • Pain from the biliary tract or pancreas
  • Ascites
  • Jaundice
  • Failure to thrive.

The symptoms of cholestasis sometimes look like other medical conditions. Always consult your child’s doctor for a diagnosis.

What is the treatment for cholestasis?

Your child’s doctor will figure out the best treatment for your child based on:

  • The child’s age
  • The child’s overall health and medical history
  • The extent of the cholestasis symptoms
  • The child’s ability to handle specific medications, procedures or therapies
  • How long the cholestasis is expected to last
  • The family’s opinion or preference.

Biliary atresia should be attended to before two months of age.

The goals of treating cholestasis are to relieve the itching and prevent complications. Itching may be treated with medication. Medication is sometimes used to help lower the amount of bile acids. Surgery is the treatment for children with biliary atresia.