What is the primary issue in obstructive liver disease?

In obstructive liver disease, the primary issue is that bile excretion is blocked. This obstruction can arise from various causes such as gallstones, tumors, or strictures in the bile ducts, preventing bile from being adequately transported from the liver to the intestine.

When bile flow is obstructed, it leads to a buildup of bile in the liver, causing cholestasis. This accumulation can result in liver cell damage and can affect the liver's ability to perform its various functions, including the metabolism of bilirubin and other substances. The obstruction can also lead to an increase in alkaline phosphatase levels and other liver function test anomalies, which are indicators of cholestatic liver disease.

Understanding the mechanics of bile flow and the consequences of its obstruction helps clarify the implications for liver health and guides the evaluation and management of patients experiencing this condition.