PSC (Primary Sclerosing Cholangitis)

Primary Sclerosing Cholangitis (PSC) is a disorder of the bile ducts of the liver. Bile is a liquid produced in the liver that helps your body break down fats and fatty vitamins (A, D, E, and K) in your food. The bile moves through the liver, into the gallbladder, and into the small intestines through a system of ducts. PSC slowly damages those ducts, both inside and out of the liver, and the resulting inflammation causes scarring that prevents the bile from flowing correctly. This damaging process is quite gradual. In the beginning stages of PSC, patients may experience little or no symptoms. If the disorder is diagnosed in the early stages, it is normally discovered while doctors are investigating something else.

Symptoms, when they do occur, may appear unrelated to the digestive tract. For example, symptoms include itching, that may be severe in some patients, and fatigue. Over time the continual blocking of the bile ducts can lead to infection resulting in fever and abdominal pain. Infections need to be treated with antibiotics.

The origins of PSC is unknown. Some researchers believe it could be an autoimmune disorder. There is a link between PSC and inflammatory bowel disease (IBD), about 90% of all PSC patients also have a form of IBD, 75% of those have ulcerative colitis, but only 10% of ulcerative colitis patients have PSC so the link between is determined.

The other promising line of research is looking at the role of infection as a cause. Bacterial infection also closely linked to ulcerative colitis and PSC. There is a possible route for bacteria, from the colon wall to circulate throughout the system, leading to an inflammation of the bile ducts. Repeated inflammation then leads to damage, which in turn leads to the development of PSC.

Over time, continuing damage can lead to liver failure. PSC is also accosted with an increased risk of bile duct and colon cancers. Because of the serious consequences of the disease it is important to maintain a regular schedule of visits and monitoring with your gastroenterologist. Your doctor will set up a schedule that is right for your symptoms and diagnosis.