[Pathophysiology of cholestasis: correlation between bile acid metabolism and liver damage]

In patients with cholestasis the biliary excretion of bile acids is diminished. Hepatic sulfation, glucuronidation and hydroxylation of bile acids are increased and enhance their urinary excretion. These metabolic pathways however, are not sufficient to prevent hepatic damage by bile salts. Ursodeoxycholic acid, a very hydrophilic and therefore untoxic bile acid, in part prevents the hepatotoxicity of more hydrophobic bile acids.