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How to treat severe itching due to a liver problem?

Wednesday, 10 September 2003
Answered by: Praveen J. Kumar
Hon. Consultant Physician and Gastroenterologist at St.Bartholomews
The Royal London and Homerton Hospitals
UK
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Q. I am suffering from BRIC (Benign Recurrent Intrahepatic Cholestasis). Six months back my gall bladder was removed due to presence of stones. Now again I am getting the same signs like unbearable itching throughout body, dark urine. Is there any medicine to give me relief from the terrible itching. I am unable to slip in the night because of this. Awaiting your reply and thanks in advance.

A.  Itching from a problem of the liver can be extremely troublesome as the patient gets little relief from scratching. The cholestasis means that the bile does not flow out of the liver due to an obstruction of the bile ducts. This means that the bile is pushed into the blood stream and then is excreted in the urine - causing the urine to become dark. Several drugs have been tried to reduce the itching and you should go and see your doctor to see if these are suitable for your particular condition. Cholestyramine (one 4gm sachet three times daily) can be helpful although it does not taste very nice. Others that have been tried include naloxone hydrochloride and naltrexone (both opioid antagonists) or rifampicin. In certain situations ursodeoxycholic acid may help. Go and ask your doctor - but in general itching is unfortunately very difficult to treat.

A.  Itching from a problem of the liver can be extremely troublesome as the patient gets little relief from scratching. The cholestasis means that the bile does not flow out of the liver due to an obstruction of the bile ducts. This means that the bile is pushed into the blood stream and then is excreted in the urine - causing the urine to become dark. Several drugs have been tried to reduce the itching and you should go and see your doctor to see if these are suitable for your particular condition. Cholestyramine (one 4gm sachet three times daily) can be helpful although it does not taste very nice. Others that have been tried include naloxone hydrochloride and naltrexone (both opioid antagonists) or rifampicin. In certain situations ursodeoxycholic acid may help. Go and ask your doctor - but in general itching is unfortunately very difficult to treat.

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