Itchy hands or feet: Liver disease may be the cause

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From: Judith Brown

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Itching in the body can have various causes. Diseases of the liver or bile cause cholestatic pruritus. There are several typical signs for him.

Anyone who has to deal with prolonged itching on the body usually suffers from a chronic form of itching. For those affected, this is not only annoying, but can also lead to a high level of suffering. Depending on where in the body the itching occurs, there are also various diseases behind the symptoms. If it is the 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 bile disease as cause – May indicate jaundice

Person scratching his big toe with his hand.
Cholestatic itching often occurs on the soles of the feet and the palms of the hands. © Andriy Popov/Imago

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

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However, if those affected do scratch, they usually do not experience any 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 trigger itching again. The symptoms can also lead to insomnia and depression. Therefore, the following three signs are typical for itching:

  • Increased symptoms in the 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 the so-called bile-carrying substances accumulate in the blood and tissues of the body due to impaired secretion of bile acids. Women with cholestatic liver disease often suffer from particularly intense itching. If liver diseases are responsible for the itching, then the body’s own opioids may also play a role.

Cholestatic pruritus is mainly treated with the so-called cholestyramine exchange resin. This should be taken before and after breakfast. By the way, when going to bed, the effect of some drugs can be accelerated ten times; the side plays an important role in this. Anyone taking other medications should also ensure they are taken at least four hours apart. Otherwise, cholestyramine can interfere with the absorption of other drugs in the body. Side effects such as flatulence or diarrhea may also occur. The antibiotic rifampicin can also be used to treat itching. However, this can cause additional liver damage as a side effect. Therefore, with this therapy, liver values ​​should be monitored regularly.

This article only contains general information on the respective health topic and is therefore not intended for self-diagnosis, treatment or medication. It in no way replaces a visit to the doctor. Unfortunately, our editors cannot answer individual questions about clinical pictures.

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