Cholestasis: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Cholestasis?
A hepatologist, a doctor who treats liver disease, or a gastroenterologist, a doctor who treats digestive problems, usually treats cholestasis. The right care depends on what is slowing or blocking the flow of bile. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is cholestasis?
Cholestasis is any condition in which the flow of bile from the liver is slowed or blocked. Bile is a digestive juice made by your liver. It travels through tubes called bile ducts to the small intestine. Bile helps break down fat. It also helps the liver get rid of toxins and wastes.
Extrahepatic cholestasis occurs outside the liver. Intrahepatic cholestasis occurs inside the liver.
Symptoms
Symptoms may include:
- Yellow skin or eyes.
- Itching.
- Dark urine.
- Clay-colored or pale stools.
- Pain in the right upper part of the abdomen.
- Nausea or vomiting.
- Trouble digesting certain foods.
Yellow skin and eyes are called jaundice. Too much bilirubin causes jaundice. Bilirubin is a yellow chemical in hemoglobin, the substance that carries oxygen in your red blood cells.
Complications may include severe itching and poor absorption of fat and fat-soluble vitamins. Having cholestasis for a very long time can cause weak bones, called osteomalacia.
Causes and who gets it
There are many causes of cholestasis. Outside the liver, causes include bile duct tumors, cysts, and narrowing of the bile duct. Stones in the common bile duct, pancreatitis, and a pancreatic tumor can also cause it.
Inside the liver, causes include alcoholic liver disease and primary biliary cholangitis. Pregnancy and liver cancer can also cause it. Serious infections that have spread through the bloodstream (sepsis) and viral hepatitis can also cause it.
Certain medicines can also cause cholestasis. Examples include some antibiotics, anabolic steroids, and birth control pills. Get vaccinated for hepatitis A and B if you are at risk.
How doctors diagnose it
Blood tests may show high levels of bilirubin and alkaline phosphatase. These tests also check for other liver conditions. You may need a liver biopsy.
Imaging tests are used to diagnose this condition. They include a CT scan, an MRI, or an ultrasound of the abdomen. A test called ERCP can also find the cause.
Treatment
The underlying cause of cholestasis must be treated. There are medicines to help the itching and other side effects of cholestasis. How well a person does depends on the disease causing the condition.
Stones in the common bile duct can often be removed. This can cure the cholestasis. Stents, which are small tubes, can be placed to open parts of the bile duct that are narrowed or blocked by cancers.
If a medicine causes the problem, it will often go away when you stop taking that medicine. Do not stop a medicine on your own. Follow your doctor's instructions. Occasionally a liver transplant is needed in severe cases.
When to see a doctor
Contact your health care provider if you have itching that does not go away, yellow skin or eyes, or other symptoms of cholestasis. Organ failure can occur if sepsis, a serious infection spread through the blood, develops. Call 911 or go to the emergency room if you have severe belly pain, confusion, trouble breathing, or fainting.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can review your symptoms and order first blood tests. They can also coordinate care with a liver specialist and follow your progress over time.
Common questions
What is the difference between intrahepatic and extrahepatic cholestasis?
Intrahepatic cholestasis occurs inside the liver, and extrahepatic cholestasis occurs outside the liver.
Can medicines cause cholestasis?
Yes, certain medicines can cause cholestasis. If a medicine is the cause, it will often go away when you stop taking that medicine. Ask your doctor before you stop any medicine.
Does cholestasis cause itching?
Yes, itching is one of the symptoms of cholestasis. There are medicines to help the itching. Itching that does not go away is a reason to contact your health care provider.
Can cholestasis be cured?
It depends on the cause. Stones in the common bile duct can often be removed, which can cure the cholestasis. Occasionally a liver transplant is needed in severe cases.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
