Primary sclerosing cholangitis (PSC) is a chronic disease that damages your bile ducts. This is an uncommon disease, and is most likely to occur in people who have inflammatory bowel disease (IBD). Here’s what you need to know about PSC.
Causes and Risk Factors
There is no clear cause of PSC in general. It’s possible that it can occur in people who have a genetic predisposition to the disease when their immune system responds to a toxin or infection. We do know that PSC tends to occur mostly in people with IBD, which includes ulcerative colitis and Crohn’s disease. PSC tends to occur more often in men and people with Northern European heritage, and is most often diagnosed between 30 and 40 (though it can occur at any age).
Symptoms of Primary Sclerosing Cholangitis
In people with PSC, their bile ducts become blocked by inflammation and scarring over time. PSC is a very slowly progressing disease- many people do not have any symptoms until several years into having the disease. Symptoms of PSC early on include itching, fatigue, and abdominal pain. As it progresses, symptoms can include weight loss, fever, an enlarged liver or spleen, and night sweats. Depending on the person, these symptoms can appear more quickly or slowly.
Diagnosing Primary Sclerosing Cholangitis
In many cases, doctors diagnose PSC incidentally while doing blood testing or an X-ray for an unrelated condition. This is due to the often slow progression of PSC symptoms (as mentioned before)- many people do not have any PSC symptoms that would lead them to go to their doctor. However, there are a few diagnostic tests doctors use to identify this disease. They can perform a blood test to check your liver function, which can support a PSC diagnosis. Additionally, they may take an MRI of your bile ducts to visualize them and identify any signs of PSC. Finally, if other diagnostic testing is inconclusive, they may perform a liver biopsy by removing some liver tissue with a needle and testing it in a lab.
Complications and Treatment
People with PSC and IBD are at an increased risk of colorectal cancer. They also have an increased risk of bile duct cancer and cirrhosis. As such, they should consult closely with a medical provider to monitor their condition over time.
Treating PSC involves first managing the symptoms and mitigating complications from the disease. Doctors can treat itching with specific medications they can prescribe. Sometimes, backed up bile (due to narrowed ducts) can cause recurring bacterial infections; in this case, doctors may prescribe antibiotics. Bile ducts can also become blocked due to scarring and inflammation in people with PSC. Doctors can either place a stent in the bile duct or dilate the bile duct with an endoscopic procedure. However, blockage can sometimes be a sign of cancer or a precursor to liver failure. In serious cases of PSC, you may need to pursue a liver transplant. This is the only way to fully treat the disease.
There are some lifestyle changes you can make to help manage PSC as well. Avoid alcohol, maintain a healthy weight, get vaccinated against Hepatitis A and B, and follow your doctor’s prescriptions carefully. A combination of lifestyle changes and treatments targeting both symptoms and potential complications is often the best course of action for people with PSC. You should consult with your doctor to establish the best plan of care.
Our experienced team at GHP has years of experience treating patients with liver conditions. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.