Itchy hands or feet can be a symptom of jaundice

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Out: Judith Braun


Itching on the body can have various causes. Disease of the liver or bile leads to cholestatic pruritus. There are several typical signs for him.

Those who have to fight with long-term itching on the body usually suffer from a chronic form of itching. This is not only uncomfortable for the sufferer, but can also lead to a high level of suffering. Depending on where on the body the itching occurs, there are also different diseases behind the symptoms. If it is so-called cholestatic itching, the cause lies in diseases of the liver or gallbladder. This can be shown by three typical signs.

Cholestatic pruritus: Liver or biliary disease as cause – May indicate jaundice

Cholestatic itching often occurs on the soles of the feet and palms of the hands. © Andriy Popov/Imago

Cholestatic itching appears in the early stages of the disease and can indicate, for example, jaundice. Itching is the predominant symptom in 80 percent of patients with primary biliary cirrhosis (PBC) or primary sclerosing cholangitis (PSC). It is a rare autoimmune disease of the liver in which the bile ducts in the bile become inflamed and destroyed over time. Chronic pruritus also occurs in 5 to 15 percent of patients with chronic hepatitis C infection. In contrast, this condition occurs relatively rarely in chronic hepatitis B infection and alcoholic liver disease.

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However, if sufferers scratch, they usually experience no relief from cholestatic itching. Instead, secondary skin changes may occur. These include, for example, skin abrasions, bleeding, scabs, small wounds and itchy nodules (prurigo nodularis). These can cause itching again. Symptoms can also lead to insomnia and depression. Therefore, the following three symptoms are typical for itching:

  • An increase in symptoms in the early evening and at night
  • Itching on the soles of the feet and on the palms of the hands
  • Secondary skin changes

Itching from liver or gallbladder disease: what happens in the body and how to treat it

Itching can occur when so-called bile substances accumulate in the blood and body tissues as a result of impaired bile acid secretion. Women with cholestatic liver disease often suffer from particularly severe itching. If liver disease is responsible for the itching, then the body’s own opioids may also play a role.

Cholestatic itching is primarily treated with a so-called cholestyramine exchange resin. It should be taken before and after breakfast. After all, when lying down, the effect of some drugs can be accelerated tenfold – the side plays an important role in this. Anyone taking other medications must also ensure that they are taken at least four hours apart. Otherwise, cholestyramine may interfere with the absorption of other drugs in the body. Side effects such as gas or diarrhea may also occur. The antibiotic rifampicin can also be used to treat itching. However, this can cause further liver damage as a side effect. Liver values ​​should therefore be checked regularly during this therapy.

This article contains only general information on the relevant health topic and is therefore not intended for self-diagnosis, treatment or medication. In no case does it replace a doctor’s visit. Unfortunately, our editors are not authorized to answer individual questions regarding clinical images.

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