Pruritus and Primary Sclerosing Cholangitis
What is pruritis?
Pruritis is an itching in the skin, which occurs without visible outward changes. Next to pain it is the second most common complaint dealt with by dermatologists.
For those who suffer from pruritus, the feeling can range from annoying to excruciating. It can lead to limited ability to work or insomnia and ultimately to physical and mental exhaustion. In extreme cases, patients become suicidal because of the continual itching.
Treatments for pruritus
Pruritus is therapeutically difficult to treat. Often the itching is associated with diseases of the biliary tract within the liver. According to the latest findings, the itching may be caused by endogenous opioids at the nerve endings in the brain.
Drug treatment with opiate antagonists may be useful in these cases. Other drugs, such as the mood sertaline (a serotonin reuptake inhibitor, SSRI), can be successful.
If you have liver insufficiency, accompanied by worsening pruritus, there is danger of further liver damage due to the increased medication.
Liver dialysis for pruritus patients
Extracorporeal albumin dialysis can be successfully used in difficult cases. See liver dialysis for further details.
For patients with intractable pruritus a case review and a physical examination is conducted by a specialist in liver dialysis with a medical background in internal medicine and a focus on liver disease.
If all known medical treatments have proven ineffective and itching still occurs in connection with liver disease, the patient is checked for suitability of liver dialysis.
If there are no contraindications (e.g. unstable blood pressure or high risk of bleeding) the patient can be selected as a candidate and treatment will start.
Liver dialysis requires a strong blood flow so the specialist must decide what is the optimal access (peripheral veins or central veins).
In some cases the liver dialysis specialist will require a critical care specialist or a consultant surgeon to assist him in laying a blood access. If necessary, the position of the access may be decided with the help of an X-ray.
For severe and intractible pruritus or primary sclerosing cholangitis, liver dialysis may offer rapid relief.
MHL Liver Dialysis Enquiry Service
Our enquiry service includes the university hospital in Germany where MARS was developed.
We can also make introductions or provide direct contact information for liver dialysis in Austria, Brazil, Canada, Singapore, Philippines, UAE, UK and USA.
For further details see Liver Dialysis.