Abstract
Pruritus is a common symptom in patients with cholestatic liver diseases. It appears in up to 80 % patients with primary biliary cholangitis or primary sclerotising cholangitis.
Pruritus itself has no significance for the prognosis of the liver disease progression, but it can significantly lower the patient's quality of life. Bile acids and endogenous opioids have been considered as the main pruritogenic substances, but recently it has been found out that lysophosphatidic acid plays a significant role in development of pruritus as well.
Treatment with cholestyramine resin is the main therapeutic measure for such cases, other drugs which can be used include rifampicin, naltrexone or sertraline. Ursodeoxycholic acid is the drug of choice for cases of pruritus accompanying intrahepatic cholestasis of pregnant patients.
New therapeutic procedures can utilise for example the possibilities of influencing ileal transporter of bile acids or the enzyme autotaxin, which produces lysophosphatidic acid.