Sclerosing Cholangitis

Sclerosing cholangitis is a chronic liver disease characterized by inflammation and scarring of the bile ducts, which are the tubes that carry bile from the liver to the gallbladder and small intestine.

Types of Sclerosing Cholangitis

There are two main types of sclerosing cholangitis:

• Primary Sclerosing Cholangitis (PSC): This is the most common type and is characterized by inflammation and scarring of the bile ducts without any known cause.
• Secondary Sclerosing Cholangitis: This type is caused by a known factor, such as injury to the bile ducts, infection, or certain medications.

Causes and Risk Factors

The exact cause of primary sclerosing cholangitis is not known, but it is believed to be an autoimmune disease, where the immune system mistakenly attacks the bile ducts. Certain risk factors may increase the likelihood of developing PSC, including:

• Inflammatory bowel disease (IBD), such as ulcerative colitis or Crohn's disease
• Family history of PSC
• Genetic predisposition

Symptoms

The symptoms of sclerosing cholangitis may vary, but common ones include:

• Fatigue
• Weight loss
• Abdominal pain
• J jaundice (yellowing of the skin and eyes)
• Itching
• Dark urine
• Pale stools

Diagnosis

Sclerosing cholangitis is typically diagnosed using a combination of:

• Medical history and physical examination
• Liver function tests (LFTs)
• Imaging studies, such as ultrasound, CT scan, or MRI
• Endoscopic retrograde cholangiopancreatography (ERCP)
• Bile duct biopsy

Treatment and Management

Treatment for sclerosing cholangitis aims to manage symptoms, slow disease progression, and prevent complications. This may include:

• Medications to reduce inflammation and itching
• Ursodeoxycholic acid (UDCA) to improve bile flow
• Antibiotics to treat infections
• Surgery to repair or remove damaged bile ducts
• Liver transplantation in advanced cases

Complications and Prognosis

If left untreated, sclerosing cholangitis can lead to serious complications, including:

• Bile duct narrowing or blockage
• Cholestasis (bile buildup in the liver)
• Cirrhosis (scarring of the liver)
• Liver failure
• Bile duct cancer

The prognosis for sclerosing cholangitis varies depending on the severity of the disease and the effectiveness of treatment. With proper management, many people with PSC can lead active lives, but the disease may progress over time, requiring ongoing medical care.