Primary Sclerosing Cholangitis (PSC) | Loyola Medicine

Primary Sclerosing Cholangitis

Overview and Facts about Primary Sclerosing Cholangitis

Primary sclerosing cholangitis (PSC) occurs when your bile ducts, which carry digestive liquids from your liver to your small intestine, become inflamed and scars build up on the ducts. Because of these scars, your bile ducts harden and narrow, leading to serious liver damage.

Although it progresses slowly, those with PSC have a higher than normal risk of infections, liver failure and bile duct or liver tumors.

Symptoms and Signs of Primary Sclerosing Cholangitis

In the initial stages of primary sclerosing cholangitis, you may feel tired or your skin may itch more than normal. As the disease progresses, your PSC symptoms worsen, and you may experience:

  • Chills
  • Enlarged liver or spleen
  • Fever
  • Jaundice (yellowing of the skin and eyes)
  • Night sweats
  • Pain in the upper right abdomen
  • Weight loss

Causes and Risk Factors of Primary Sclerosing Cholangitis

Although the root cause of this digestive health disorder is unknown, it has been linked to other conditions, including inflammatory bowel diseases like ulcerative colitis and Crohn’s disease. The onset of PSC may also be linked to a reaction in your immune system to an infection or trigger.

Certain risk factors can make you more likely to develop primary sclerosing cholangitis, including:

  • Being between 30-50
  • Being male
  • Having a Northern European heritage

Tests and Diagnosis of Primary Sclerosing Cholangitis

Depending on the range of your symptoms, your doctor may test for primary sclerosing cholangitis by looking at your liver function through laboratory screens, or taking an MRI of your bile ducts. In some circumstances, they may request an endoscopic retrograde cholangiopancreatography (ERCP), a special type of X-ray to look at your bile ducts and how they function. Your doctor may also recommend testing a sample of liver tissue to see the extent of liver damage that’s already occurred due to PSC.

Treatment and Care for Primary Sclerosing Cholangitis

There is no cure for primary sclerosing cholangitis, but you can manage its symptoms and minimize liver damage. Your doctor may recommend something to reduce your itch, including antihistamines, antibiotics or bile acid sequestrants, which are medications that bind to your bile acids.

One of the common side effects of PSC is that your body doesn’t properly absorb certain vitamins and nutrients. To help combat this, your doctor may suggest vitamin supplements taken either daily, or through IV infusions. If PSC causes weak bones, they also may advise you to take vitamin D and calcium supplements.

When a bile duct blockage occurs, your doctor may recommend opening the blockages with balloon dilation, or by inserting a stent to hold the duct open. If your PSC progresses and your go into liver failure, you may need a liver transplant.