Primary Sclerosing Cholangitis (PSC)

Primary sclerosing cholangitis is a disease that can cause inflammation in the bile ducts, which carry bile from the liver to the small intestine. Chronic inflammation of the bile ducts can lead to scarring, which can cause the ducts to harden and narrow. This can ultimately lead to liver damage.

Causes of Primary Sclerosing Cholangitis

A definitive cause of primary sclerosing cholangitis hasn’t been identified, but it’s believed that individuals who are diagnosed with it have a genetic predisposition to the disease.

Some of the risk factors for primary sclerosing cholangitis appear to be:

  • Age and sex – It most often occurs in men between the ages of 30 and 40.
  • Inflammatory bowel disease – A majority of PSC patients also have ulcerative colitis or Crohn's disease.
  • Geography – People with Northern European heritage have a higher risk of developing PSC.

Symptoms of Primary Sclerosing Cholangitis

It’s hard to predict how slowly or quickly primary sclerosing cholangitis will progress in an individual. Many patients continue to feel well for several years after diagnosis, which usually involves routine blood tests.

Early symptoms of PSC can include:

  • Itchy skin
  • Fatigue
  • Jaundice (yellowing of the skin and eyes)
  • Abdominal pain

When the disease progresses, some of the signs that liver damage is occurring include:

  • Fever
  • Chills
  • Weight loss
  • Night sweats
  • Enlarged liver
  • Enlarged spleen

Diagnosing Primary Sclerosing Cholangitis

There are a variety of tests and procedures that can be used to diagnose PSC. They include:

  • A liver function blood test to check liver enzyme levels
  • An MRI to examine the bile ducts
  • A bile duct X-ray
  • A liver biopsy to determine the extent of the tissue damage

Treatments for Primary Sclerosing Cholangitis

Many medications have been tried on patients with PSC, but none have been effective in slowing or reversing the liver damage it causes. A liver transplant is the only known cure for primary sclerosing cholangitis, so most treatment plans are designed to manage complications of the disease.

Options for treatment include:

  • A variety of medications designed to reduce itching
  • Courses of antibiotics to combat bacterial infections
  • Supplements to help your body absorb certain vitamins
  • Endoscopic procedures to open bile duct blockages

Tampa General Hospital’s liver disease, hepatology and transplant specialists treat adult patients with PSC and other serious liver conditions.