DIABETES

Type 2 diabetes is a lifelong disease that happens when the cells of the body can't use insulin
the right way or when the pancreas can't make enough insulin. Insulin lets blood sugar—also
called glucose—enter the body’s cells to be used for energy. When insulin is not able to do its
job, the cells can't get the sugar they need, and too much sugar builds up in the blood. Over
time, this extra sugar in the blood can damage your eyes, heart, blood vessels, nerves, and
kidneys.

More and more adults and children are getting type 2 diabetes. This is largely because of bad
eating habits and a lack of physical activity. It is important to know if you or your children are at
risk for type 2 diabetes and to know what you can do to help prevent the disease.

What causes type 2 diabetes?

You can get type 2 diabetes if:

 Your body does not respond as it should to insulin. This makes it hard for your cells to
get sugar from the blood for energy. This is called insulin resistance.

 Your pancreas does not make enough insulin.

Your weight, how active you are, and your family history all affect the way your body responds
to insulin. If you are overweight, get little or no exercise, or have family members with diabetes,
you have a greater chance of getting type 2 diabetes.

What are the symptoms?

Some people don't have symptoms, especially when diabetes is diagnosed early. This is
because the blood sugar level may rise so slowly that a person may not know that anything is
wrong. Other people may have symptoms, such as:

 Being very thirsty.

 Urinating a lot.

 Losing weight without trying.

 Having blurry vision.

  Feeling hungrier or more tired than usual.

Sometimes a person finds out that he or she has type 2 diabetes during a regular medical
checkup. Or people may find out that they have the disease during an appointment for another
health problem such as high blood pressure, an infection, or a wound that heals slowly. Some
people don't find out that they have diabetes until they have a complication from the disease,
such as vision problems, kidney disease, nerve disease, or heart and blood vessel problems.

How is type 2 diabetes diagnosed?

If your doctor thinks that you have type 2 diabetes, he or she will ask you questions about your
medical history, do a physical exam, and order a blood glucose test. A blood glucose test is a
blood test that measures the amount of sugar in your blood. The test is usually done first thing
in the morning, before you eat or drink anything.

How is it treated?

The key to treating type 2 diabetes is controlling blood sugar levels. All of the following help to
lower blood sugar:

 Eating healthy foods

 Losing weight, if you are overweight

 Getting regular exercise

 In some cases, taking medicines

Treatment for diabetes also includes checking blood sugar levels to make sure that the disease
is under control. It is important to watch for signs of high and low blood sugar. Both can cause
problems and need to be treated.

People with diabetes need regular checkups to make sure that the treatment is working and that
they do not get more serious health problems.

Can type 2 diabetes be prevented?

If you are at risk for type 2 diabetes or if you have prediabetes, you may prevent diabetes by
getting regular exercise and paying attention to what and how much you eat. If you are
overweight, losing a little weight (10 to 20 pounds) can go a long way toward preventing or
delaying the disease.

What Happens

Type 2 diabetes is a lifelong disease that affects the way your body uses food for energy. The
disease develops when the cells of the body become resistant to insulin or when the pancreas
cannot make enough insulin. Insulin is a hormone that helps your body's cells get needed
energy from sugar. When insulin is not able to do its job, too much sugar builds up in your
blood. Over time, this extra sugar in your blood can lead to problems with your eyes, heart,
blood vessels, nerves, and kidneys.

Type 2 diabetes usually develops in adulthood; however, more and more children are being
diagnosed with type 2 diabetes. Often people who have type 2 diabetes are overweight and get
little or no physical exercise.

Sometimes type 2 diabetes develops so slowly that you do not have symptoms until you already
have some more serious problems from the disease. Many people have prediabetes—when
blood sugar levels are above normal but not high enough to have diabetes—for years before
they know they develop type 2 diabetes. For more information on prediabetes, see the topic
Prediabetes.

Once you know that you have type 2 diabetes, you will work with your doctor and other health
professionals to develop the best treatment plan for you. Treatment usually includes eating
healthy foods and spreading carbohydrate throughout the day, exercising regularly, checking
your blood sugar levels often, and possibly taking medicine. Working closely with your doctor
and other health professionals can help you feel better and more in control of your disease. You
can help prevent or delay more serious health problems by keeping your blood sugar within a
safe range.
As time goes on, your pancreas may make less and less insulin, which can make it harder to
control your blood sugar level. It is important to treat your high blood sugar early anytime your
blood sugar level rises above what is safe for you. Treating high blood sugar early can help
prevent:

 A hyperosmolar state, which is a life-threatening event that can happen when the blood
sugar level is very high. It can occur when a person with type 2 diabetes has an illness, such
as a severe case of the flu or other infection; has a heart attack; is not drinking enough liquids
and becomes dehydrated; or takes medicines (diuretics) that increase fluid loss or affect
mental alertness, especially if liquids are not replaced.

 Long-term diabetes complications, which result from damage to the body's tissues.
Persistent high blood sugar can damage the eyes (diabetic retinopathy), kidneys (diabetic
nephropathy), nerves (diabetic neuropathy), heart (leading to a heart attack), and blood
vessels (leading to strokes, peripheral arterial disease, and possibly amputation).

TUBERCULOSIS

Causes

Pulmonary tuberculosis is caused by the bacteria Mycobacterium tuberculosis (M. tuberculosis).

You can get tuberculosis by breathing in air droplets from a cough or sneeze of an infected
person.

In the United States, most people will recover from primary TB infection without further evidence
of the disease. The infection may stay asleep or nonactive (dormant) for years and then
reactivate.

Most people who develop symptoms of a TB infection first became infected in the past.
However, in some cases, the disease may become active within weeks after the primary
infection.

The following people are at higher risk for active TB:

• Elderly
• Infants
• People with weakened immune systems, for example due to AIDS, chemotherapy, or
antirejection medicines given after an organ transplant

Your risk of contracting TB increases if you:

 • Are in frequent contact with people who have the disease
• Have poor nutrition
• Live in crowded or unsanitary living conditions

The following factors may increase the rate of TB infection in a population:

• Increase in HIV infections

• Increase in number of homeless people (poor environment and nutrition)
• The appearance of drug-resistant strains of TB

In the United States, there are approximately 10 cases of TB per 100,000 people. However,
rates vary dramatically by area of residence and socioeconomic class.

See also: Disseminated tuberculosis

Symptoms

The primary stage of the disease usually doesn't have symptoms. When symptoms do occur,
they may include:

• Cough (sometimes producing phlegm)

• Coughing up blood
• Excessive sweating, especially at night
• Fatigue
• Fever
• Unintentional weight loss

Other symptoms that may occur with this disease:

• Breathing difficulty
• Chest pain
• Wheezing

RENAL FAILURE:

What are the kidneys?

The kidneys play key roles in body function, not only by filtering the blood and getting rid of
waste products, but also by balancing levels of electrolytes in the body, controlling blood
pressure, and stimulating the production of red blood cells.

The kidneys are located in the abdomen toward the back, normally one of each side of the
spine. They get their blood supply through the renal arteries directly from the aorta and send
blood back to the heart via the renal veins to the vena cava. (The term "renal" is derived from
the Latin name for kidney.)
The kidneys have the ability to monitor the amount of body fluid, the concentrations of
electrolytes like sodium and potassium, and the acid-base balance of the body. They filter waste
products of body metabolism, like urea from protein metabolism and uric acid from DNA
breakdown. Two waste products in the blood can be measured: blood urea nitrogen (BUN) and
creatinine (Cr).

When blood flows to the kidney, sensors within the kidney decide how much water to excrete as
urine, along with what concentration of electrolytes. For example, if a person is dehydrated from
exercise or from an illness, the kidneys will hold onto as much water as possible and the urine
becomes very concentrated. When adequate water is present in the body, the urine is much
more dilute, and the urine becomes clear. This system is controlled by renin, a hormone
produced in the kidney that is part of the fluid and blood pressure regulation systems of the
body.

Kidneys are also the source of erythropoietin in the body, a hormone that stimulates the bone
marrow to make red blood cells. Special cells in the kidney monitor the oxygen concentration in
blood. If oxygen levels fall, erythropoietin levels rise and the body starts to manufacture more
red blood cells.

After the kidneys filter blood, the urine is excreted through the ureter, a thin tube that connects it
to the bladder. It is then stored in the bladder awaiting urination, when the bladder sends the
urine out of the body through the urethra.

What causes kidney failure?

Kidney failure can occur from an acute situation or from chronic problems.

In acute renal failure, kidney function is lost rapidly and can occur from a variety of insults to the
body. The list of causes is often categorized based on where the injury has occurred.

Prerenal causes (pre=before + renal=kidney) causes are due to decreased blood supply to the
kidney. Examples of prerenal causes are:

• Hypovolemia (low blood volume) due to blood loss

• Dehydration from loss of body fluid (vomiting, diarrhea, sweating, fever )

• Poor intake of fluids

• Medication, for example, diuretics ("water pills") may cause excessive water loss.

• Loss of blood supply to the kidney due to obstruction of the renal artery or vein.

Renal causes (damage directly to the kidney itself) include:

• Sepsis: The body's immune system is overwhelmed from infection and causes
inflammation and shutdown of the kidneys. This usually does not occur with urinary tract
infections.
 • Medications: Some medications are toxic to the kidney, including nonsteroidal anti-
inflammatory drugs like ibuprofen and naproxen. Others are antibiotics like
aminoglycosides [gentamicin (Garamycin), tobramycin], lithium (Eskalith, Lithobid),
iodine-containing medications such as those injected for radiology dye studies.

• Rhabdomyolysis: This is a situation in which there is significant muscle breakdown in

the body, and the degeneration products of muscle fibers clog the filtering system of the
kidneys. Often occurring because of trauma and crush injuries, it can also be caused by
some medications used to treat high cholesterol.

• Multiple Myeloma

• Acute glomerulonephritis or inflammation of the glomeruli, the filtering system of the

kidneys. Many diseases can cause this inflammation including systemic lupus
erythematosus, Wegener's granulomatosis, and Goodpasture syndrome.

Post renal causes (post=after + renal= kidney) are due to factors that affect outflow of the
urine:

• Obstruction of the bladder or the ureters can cause back pressure when there is no
place for the urine to go as the kidneys continue to work. When the pressure increases
enough, the kidneys shut down.

• Prostatic hypertrophy or prostate cancer may block the urethra and prevents the bladder
from emptying.

• Tumors in the abdomen that surround and obstruct the ureters.

• Kidney stones

Chronic renal failure develops over months and years. The most common causes of chronic
renal failure are related to:

• Poorly controlled diabetes

• Poorly controlled high blood pressure

• Chronic glomerulonephritis

Less common causes:

• Polycystic Kidney Disease

• Reflux nephropathy

• Kidney stones

• Prostate disease
What is hyperthyroidism?

Hyperthyroidism is a condition in which an overactive thyroid gland is producing an excessive

amount of thyroid hormones that circulate in the blood. ("Hyper" means "over" in Greek).
Thyrotoxicosis is a toxic condition that is caused by an excess of thyroid hormones from any
cause. Thyrotoxicosis can be caused by an excessive intake of thyroid hormone or by
overproduction of thyroid hormones by the thyroid gland. Because both physicians and patients
often use these words interchangeably, we will take some liberty by using the term
"hyperthyroidism" throughout this article.

What are thyroid hormones?

Thyroid hormones stimulate the metabolism of cells. They are produced by the thyroid gland.
The thyroid gland is located in the lower part of the neck, below the Adam's apple. The gland
wraps around the windpipe (trachea) and has a shape that is similar to a butterfly formed by two
wings (lobes) and attached by a middle part (isthmus).

The thyroid gland removes iodine from the blood (which comes mostly from a diet of foods such
as seafood, bread, and salt) and uses it to produce thyroid hormones. The two most important
thyroid hormones are thyroxine (T4) and triiodothyronine (T3) representing 99.9% and 0.1% of
thyroid hormones respectively. The hormone with the most biological activity (for example, the
greatest effect on the body) is actually T3. Once released from the thyroid gland into the blood,
a large amount of T4 is converted to T3 - the more active hormone that affects the metabolism
of cells.

Some common causes of hyperthyroidism include:

• Graves' Disease

• Functioning adenoma ("hot nodule") and toxic multinodular goiter (TMNG)

• Excessive intake of thyroid hormones

• Abnormal secretion of TSH

• Thyroiditis (inflammation of the thyroid gland)

• Excessive iodine intake

Graves' Disease

Graves' disease, which is caused by a generalized overactivity of the thyroid gland, is the most
common cause of hyperthyroidism. In this condition, the thyroid gland usually is renegade,
which means it has lost the ability to respond to the normal control by the pituitary gland via
TSH. Graves' disease is hereditary and is up to five times more common among women than
men. Graves' disease is thought to be an autoimmune disease, and antibodies that are
characteristic of the illness may be found in the blood. These antibodies include thyroid
stimulating immunoglobulin (TSI antibodies), thyroid peroxidase antibodies (TPO), and TSH
receptor antibodies. The triggers for Grave's disease include:
 • stress,

• smoking,

• radiation to the neck,

• medications, and

• infectious organisms such as viruses.

Graves' disease can be diagnosed by a standard, nuclear medicine thyroid scan which shows
diffusely increased uptake of a radioactively-labeled iodine. In addition, a blood test may reveal
elevated TSI levels.

Grave's disease may be associated with eye disease (Graves' ophthalmopathy) and skin
lesions (dermopathy ). Ophthalmopathy can occur before, after, or at the same time as the
hyperthyroidism. Early on, it may cause sensitivity to light and a feeling of "sand in the eyes."
The eyes may protrude and double vision can occur. The degree of ophthalmopathy is
worsened in those who smoke. The course of the eye disease is often independent of the
thyroid disease, and steroid therapy may be necessary to control the inflammation that causes
the ophthalmopathy. In addition, surgical intervention may be required. The skin condition
(dermopathy) is rare and causes a painless, red , lumpy skin rash that appears on the front of
the legs.

Functioning Adenoma and Toxic Multinodular Goiter

The thyroid gland (like many other areas of the body) becomes lumpier as we get older. In the
majority of cases, these lumps do not produce thyroid hormones and require no treatment.
Occasionally, a nodule may become "autonomous," which means that it does not respond to
pituitary regulation via TSH and produces thyroid hormones independently. This becomes more
likely if the nodule is larger that 3 cm. When there is a single nodule that is independently
producing thyroid hormones, it is called a functioning nodule. If there is more than one
functioning nodule, the term toxic, multinodular goiter is used. Functioning nodules may be
readily detected with a thyroid scan.

Excessive intake of thyroid hormones

Taking too much thyroid hormone medication is actually quite common. Excessive doses of
thyroid hormones frequently go undetected due to the lack of follow-up of patients taking their
thyroid medicine. Other persons may be abusing the drug in an attempt to achieve other goals
such as weight loss. These patients can be identified by having a low uptake of radioactively-
labelled iodine (radioiodine) on a thyroid scan.

Abnormal secretion of TSH

A tumor in the pituitary gland may produce an abnormally high secretion of TSH (the thyroid
stimulating hormone). This leads to excessive signaling to the thyroid gland to produce thyroid
hormones. This condition is very rare and can be associated with other abnormalities of the
pituitary gland. To identify this disorder, an endocrinologist performs elaborate tests to assess
the release of TSH.
Treatment Options for Hyperthyroidism

Written by James Norman MD, FACS, FACE

There are readily available and effective treatments for all common types of
hyperthyroidism. Some of the symptoms of hyperthyroidism (such as tremor and palpitations,
which are caused by excess thyroid hormone acting on the cardiac and nervous system) can be
improved within a number of hours by medications called beta-blockers (eg, propranolol;
Inderal).

These drugs block the effect of the thyroid hormone but don't have an effect on the thyroid itself,
thus beta blockers do not cure the hyperthyroidism and do not decrease the amount of thyroid
hormone being produced; they just prevent some of the symptoms. For patients with temporary
forms of hyperthyroidism (thyroiditis or taking excess thyroid medications), beta blockers may
be the only treatment required. Once the thyroiditis (inflammation of the thyroid gland) resolves
and goes away, the patient can be taken off these drugs.

Anti-thyroid Drugs

For patients with sustained forms of hyperthyroidism, such as Graves' diseas or toxic
nodular goiter, anti-thyroid medications are often used. The goal with this form of drug
therapy is to prevent the thyroid from producing hormones.

Two common drugs in this category are methimazole and propylthiouracil (PTU), both of which
actually interfere with the thyroid gland's ability to make its hormones. The illustration shows
that some hormone is made, but the thyroid becomes much less efficient. When taken faithfully,
these drugs are usually very effective in controlling hyperthyroidism within a few weeks.

Anti-thyroid drugs can have side effects such as rash, itching, or fever, but these are
uncommon. Very rarely, patients treated with these medications can develop liver inflammation
or a deficiency of white blood cells therefore, patients taking antithyroid drugs should be aware
that they must stop their medication and call their doctor promptly if they develop yellowing of
the skin, a high fever, or severe sore throat. The main shortcoming of antithyroid drugs is that
the underlying hyperthyroidism often comes back after they are discontinued. For this reason,
many patients with hyperthyroidism are advised to consider a treatment that permanently
prevents the thyroid gland from producing too much thyroid hormone.
Radioactive Iodine Treatment

Radioactive iodine is the most widely-recommended permanent treatment of

hyperthyroidism. This treatment takes advantage of the fact that thyroid cells are the only cells
in the body which have the ability to absorb iodine. In fact, thyroid hormones are experts at
doing just that.

By giving a radioactive form of iodine, the thyroid cells which absorb it will be damaged or killed.
Because iodine is not absorbed by any other cells in the body, there is very little radiation
exposure (or side effects) for the rest of the body. Radioiodine can be taken by mouth without
the need to be hospitalized. This form of therapy often takes one to two months before the
thyroid has been killed, but the radioactivity medicine is completely gone from the body within a
few days. The majority of patients are cured with a single dose of radioactive iodine.

The only common side effect of radioactive iodine treatment is underactivity of the thyroid gland.
The problem here is that the amount of radioactive iodine given kills too many of the thyroid
cells so that the remaining thyroid does not produce enough hormone, a condition called
hypothyroidism.There is no evidence that radioactive iodine treatment of hyperthyroidism
causes cancer of the thyroid gland or other parts of the body, or that it interferes with a
woman's chances of becoming pregnant and delivering a healthy baby in the future. It is also
important to realize that there are different types of radioactive iodine (isotopes). The type
used for thyroid scans (iodine scans) as shown in the picture below give up a much milder type
of radioactivity which does not kill thyroid cells.

What is hypothyroidism?

Hypothyroidism is a condition characterized by abnormally low thyroid hormone production.

There are many disorders that result in hypothyroidism. These disorders may directly or
indirectly involve the thyroid gland. Because thyroid hormone affects growth, development, and
many cellular processes, inadequate thyroid hormone has widespread consequences for the
body.

This article will focus specifically on hypothyroidism in adults.

What are thyroid hormones?

Thyroid hormones are produced by the thyroid gland. This gland is located in the lower part of
the neck, below the Adam's apple. The gland wraps around the windpipe (trachea) and has a
shape that is similar to a butterfly - formed by two wings (lobes) and attached by a middle part
(isthmus).

The thyroid gland uses iodine (mostly available from the diet in foods such as seafood, bread,
and salt) to produce thyroid hormones. The two most important thyroid hormones are thyroxine
(T4) and triiodothyronine (T3), which account for 99% and 1% of thyroid hormones present in
the blood respectively. However, the hormone with the most biological activity is T3. Once
released from the thyroid gland into the blood, a large amount of T4 is converted into T3 - the
active hormone that affects the metabolism of cells

Cerebrovascular accident:

The sudden death of some brain cells due to lack of oxygen when the blood flow to the brain is
impaired by blockage or rupture of an artery to the brain. A CVA is also referred to as a stroke.

Symptoms of a stroke depend on the area of the brain affected. The most common symptom is
weakness or paralysis of one side of the body with partial or complete loss of voluntary
movement or sensation in a leg or arm. There can be speech problems and weak face muscles,
causing drooling. Numbness or tingling is very common. A stroke involving the base of the brain
can affect balance, vision, swallowing, breathing and even unconsciousness.

A stroke is a medical emergency. Anyone suspected of having a stroke should be taken

immediately to a medical facility for diagnosis and treatment.

COPD, or chronic obstructive pulmonary (PULL-mun-ary) disease, is a progressive disease that

makes it hard to breathe. "Progressive" means the disease gets worse over time.

COPD can cause coughing that produces large amounts of mucus (a slimy substance),
wheezing, shortness of breath, chest tightness, and other symptoms.

Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used
to smoke. Long-term exposure to other lung irritants, such as air pollution, chemical fumes, or
dust, also may contribute to COPD.

Overview

To understand COPD, it helps to understand how the lungs work. The air that you breathe goes
down your windpipe into tubes in your lungs called bronchial tubes, or airways.

The airways are shaped like an upside-down tree with many branches. At the end of the
branches are tiny air sacs called alveoli (al-VEE-uhl-eye).

The airways and air sacs are elastic. When you breathe in, each air sac fills up with air like a
small balloon. When you breathe out, the air sac deflates and the air goes out.

In COPD, less air flows in and out of the airways because of one or more of the following:
 • The airways and air sacs lose their elastic quality.
• The walls between many of the air sacs are destroyed.
• The walls of the airways become thick and inflamed (swollen).
• The airways make more mucus than usual, which tends to clog the airways.

What Are the Signs and Symptoms of COPD?

The signs and symptoms of COPD include:

• An ongoing cough or a cough that produces large amounts of mucus (often called
"smoker's cough")
• Shortness of breath, especially with physical activity
• Wheezing (a whistling or squeaky sound when you breathe)
• Chest tightness

These symptoms often occur years before the flow of air into and out of the lungs declines.
However, not everyone who has these symptoms has COPD. Likewise, not everyone who has
COPD has these symptoms.

Some of the symptoms of COPD are similar to the symptoms of other diseases and conditions.
Your doctor can determine if you have COPD.

If you have COPD, you may have frequent colds or flu. If your COPD is severe, you may have
swelling in your ankles, feet, or legs; a bluish color on your lips due to low levels of oxygen in
your blood; and shortness of breath.

COPD symptoms usually slowly worsen over time. At first, if symptoms are mild, you may not
notice them, or you may adjust your lifestyle to make breathing easier. For example, you may
take the elevator instead of the stairs.

Over time, symptoms may become bad enough to see a doctor. For example, you may get short
of breath during physical exertion.

How severe your symptoms are depends on how much lung damage you have. If you keep
smoking, the damage will occur faster than if you stop smoking. In severe COPD, you may have
other symptoms, such as weight loss and lower muscle endurance.

Some severe symptoms may require treatment in a hospital. You—with the help of family
members or friends, if you're unable—should seek emergency care if:
 • You're having a hard time catching your breath or talking.
• Your lips or fingernails turn blue or gray. (This is a sign of a low oxygen level in your
blood.)
• You're not mentally alert.
• Your heartbeat is very fast.
• The recommended treatment for symptoms that are getting worse isn't working.

Cholestasis

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Bile

Drug-induced cholestasis

Cholestasis is any condition in which the flow of bile from the liver is blocked.

Causes

There are many causes of cholestasis.

Extrahepatic cholestasis occurs outside the liver. It can be caused by:

• Bile duct tumors

• Cysts
• Narrowing of the bile duct (strictures)
• Stones in the common bile duct
• Pancreatitis
• Pancreatic tumor or pseudocyst
• Pressure on an organ due to a nearby mass or tumor
• Primary sclerosing cholangitis

Intrahepatic cholestasis occurs inside the liver. It can be caused by:

 • Alcoholic liver disease
• Amyloidosis
• Bacterial abscess in the liver
• Being fed through a vein (IV)
• Lymphoma
• Pregnancy
• Primary biliary cirrhosis
• Primary sclerosing cholangitis
• Sarcoidosis
• Serious infections that have spread through the bloodstream (sepsis)
• Tuberculosis
• Viral hepatitis
• Sjogren syndrome

Certain medications can also cause cholestasis. See: Drug-induced cholestasis

Symptoms

• Clay-colored or white stools

• Dark urine
• Inability to digest certain foods
• Itching
• Nausea or vomiting
• Pain in the right upper part of the abdomen
• Yellow skin or eyes

Exams and Tests

Blood tests may show higher than normal levels of bilirubin and alkaline phosphatase.

Imaging tests are used to diagnose this condition. Tests include:

• CT scan of the abdomen

• MRI of the abdomen
• Endoscopic retrograde cholangiopancreatography (ERCP) (can also determine cause)
• Ultrasound of the abdomen

Treatment

The underlying cause of cholestasis must be treated.

Outlook (Prognosis)

How well a person does depends on the disease causing the condition. Stones in the common
bile duct usually can be removed, curing the cholestasis.

Stents can be placed to open areas of the common bile duct that are narrowed or blocked by
cancers.
Possible Complications

• Diarrhea
• Organ failure can occur if sepsis develops
• Poor absorption of fat and fat-soluble vitamins
• Severe itching
• Weak bones (osteomalacia) and osteoporosis (due to very long-term cholestasis)

When to Contact a Medical Professional

Call your health care provider if you have:

• Persistent itching
• Yellow skin or eyes
• Other symptoms of cholestasis

Prevention

Get vaccinated for hepatitis A and B if you are at risk. Avoid intravenous drug use and needle
sharing.

Alternative Names

Intrahepatic cholestasis; Extrahepatic cholestasis