PHARMACOLOGICAL TREATMENT OF CHOLESTASIS

Cholestasis, the failure to produce bile, ranges in its manifestations from a biochemical abnormality without clinical significance over annoying illnesses with fatigue and pruritus but without propensity for progression to diseases, which inexorably lead to malnutrition, hepatocellular failure, and death. This variety of clinical presentations has to be taken into account when considering a patient for treatment; moreover, the treating physician should select appropriate measures of efficacy of treatment. This review therefore will consider some pathogenetically important features of cholestasis as they relate to novel pharmacologic approaches and evaluate measures of efficacy before discussing old and novel forms of treatment of cholestasis.