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Management

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

General management:

  • nutrition - problem is that of intestinal bile salt deficiency:
    • calorie and protein intake must be maintained but fat reduced. Additional fat supplied by medium chain triglycerides e.g. Portagen or coconut oil
    • fat soluble vitamins - A, D, E, K - may need to be supplemented if signs of deficiency
  • pruritus - options:
    • external biliary drainage
    • cholestyramine
    • phototherapy
    • ursodeoxycholic acid
    • rifampicin
  • hepatic osteodystrophy may require vitamin D, phosphate or calcium; oestrogens in postmenopausal women

Extrahepatic cholestasis often requires surgical management.

Note that the use of clofibrate therapy in the hyperlipidaemia associated of cholestasis is associated with a raised serum cholesterol.

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