Cholestyramine for long term relief of the pruritus complicating intrahepatic cholestasis

The cause of the pruritus suffered by patients with obstructive jaundice is not known.Although bile salts have often been incriminated,!patients can be relieved by methyl testosterone,2 or norethandrolone (Nilevar)3 without any fall in serum bile acid levels.Such agents relieve pruritus at the expense of deepening jaundice and hirsutism. 4Cholestyramine is a basic anion exchange resin which has been shown to relieve pruritus, perhaps secondarily to fecal removal of bile salts and to the interruption of their enterohepatic circulation. 5 -8 The present paper reports the long term effects of cholestyramine therapy in patients with chronic intrahepatic cholestasis.Their clinical progress is compared with that of groups of patients with primary biliary cirrhosis receiving norethandrolone or untreated. Materials and MethodsTwenty-seven patients suffering from chronic intrahepatic cholestasis were treated with cholestyramine, 23 of these for periods of 6 to 32 months (table 1).In each case the diagnosis was confirmed by the hepatic histological picture and by surgical exploration of the biliary system to exclude main bile duct obstruction.Seventeen patients had primary biliary