Cholestasis is defined as impaired secretion of bile. Pruritus is a complication of cholestasis including that associated with mutations in genes that code for transporters in the hepatocyte and from inflammatory liver diseases. In this regard, pruritus is more common in conditions characterized by bile duct inflammatory destruction and ductopenia including primary bile cirrhosis primary biliary cirrhosis (PBC) than in those characterized by hepatocellular injury such as chronic viral hepatitis. The pruritus of cholestasis tends to be generalized. It leads to scratching, sometimes violent, resulting in excoriations and prurigo nodularis. This type of pruritus can lead to sleep deprivation, and in some patients, to suicidal ideations. Intractable pruritus from liver disease is an indication for liver transplantation even in the absence of liver failure. Accordingly, pruritus is a complication of liver disease that requires specific management and intense research in an effort to design effective antipruritic medications. Women with cholestasis of pregnancy can experience severe pruritus especially in the third trimester. The pruritus from cholestasis of pregnancy resolves itself after delivery; if it does not, investigations to rule out liver disease are indicated. In patients with PBC the pruritus has not been consistently reported to correlate with biological markers of disease. Also, in PBC the presence of intrahepatic florid bile duct lesions and granulomata were significantly related to the severity of pruritus (and fatigue), which was assessed subjectively, on the day of the biopsy. This observation is interesting because, although it is difficult to infer the degree of cholestasis from a liver biopsy, as there is sampling error, the fact that patients with stage I PBC can experience severe pruritus may suggest an important release of pruritogens in association with active inflammatory destruction of biliary epithelial cells, which characterizes this stage. The pruritus can persist and remit throughout the course of the disease, and as the disease progresses to liver failure, the pruritus tends to cease, as if a certain degree of liver function were necessary for pruritogen(s) or its cofactors to be produced or for the sensation to be perceived. In relation with PBC, it was also reported that presentation of the disease at less than 50 years of age correlated with an increased likelihood of reporting symptoms (and not responding to ursodeoxycholic acid, the drug approved for the treatment of this disease).
胆汁淤积被定义为胆汁分泌受损。瘙痒是胆汁淤积的一种并发症，包括与肝细胞转运体编码基因突变以及炎症性肝病相关的瘙痒。在这方面，瘙痒在以胆管炎性破坏和胆管减少为特征的疾病（如原发性胆汁性肝硬化）中比在以肝细胞损伤为特征的疾病（如慢性病毒性肝炎）中更为常见。胆汁淤积引起的瘙痒往往是全身性的。它会导致搔抓，有时很剧烈，从而引起皮肤擦伤和结节性痒疹。这种类型的瘙痒会导致睡眠不足，在一些患者中还会引发自杀念头。即使在没有肝功能衰竭的情况下，肝病引起的顽固性瘙痒也是肝移植的指征。因此，瘙痒是一种需要特殊管理和深入研究以设计有效止痒药物的肝病并发症。妊娠胆汁淤积的女性可能会经历严重的瘙痒，尤其是在妊娠晚期。妊娠胆汁淤积引起的瘙痒在分娩后会自行缓解；如果没有缓解，则需要进行检查以排除肝病。在原发性胆汁性肝硬化患者中，瘙痒与疾病的生物学标志物之间的相关性尚未得到一致报道。此外，在原发性胆汁性肝硬化中，肝内明显的胆管病变和肉芽肿的存在与瘙痒（和疲劳）的严重程度显著相关，瘙痒（和疲劳）是在活检当天通过主观评估的。这一观察结果很有趣，因为尽管由于存在抽样误差，很难从肝活检中推断胆汁淤积的程度，但原发性胆汁性肝硬化I期患者会经历严重瘙痒这一事实可能表明，与胆管上皮细胞的活动性炎性破坏相关的致痒原大量释放，而这正是该阶段的特征。瘙痒在疾病过程中可能会持续和缓解，随着疾病进展至肝功能衰竭，瘙痒往往会停止，就好像一定程度的肝功能对于致痒原或其辅助因子的产生或对于瘙痒感觉的感知是必要的。关于原发性胆汁性肝硬化，还报道称，发病年龄小于50岁与报告症状（以及对熊去氧胆酸无反应，熊去氧胆酸是被批准用于治疗该病的药物）的可能性增加相关。
