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Primary sclerosing cholangitis

Cholangitis sclerosans primaria · Primární sklerozující cholangitida

What it is

The bile ducts inside and outside the liver scar and narrow, slowly leading to cirrhosis; most patients also have ulcerative colitis.

Symptoms & signs

  • Often none at first
  • itching
  • tiredness
  • jaundice
  • pain under the right ribs
  • fever and chills (cholangitis)

🚩 Get help if…

  • call 112 / 911 now Fever with shivers, belly pain and yellow skin
  • call 112 / 911 now Vomiting blood or black, tarry stools
  • see a doctor soon Yellow skin or eyes getting worse, or severe itch
  • see a doctor soon Losing weight or new pain under the right ribs

Where it strikes

Medical treatment

  • MRCP
  • ursodeoxycholic acid (debated)
  • stretching of tight strictures
  • yearly colonoscopy and scans for cancer
  • liver transplant

Natural & lifestyle

  • No alcohol
  • vaccination against hepatitis A and B
  • vitamin D and bone care

Emerging & experimental

  • Norucholic acid
  • oral vancomycin
  • FXR agonists

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Oral vancomycin — small studies improve blood tests, especially in children early / small studies
  • Curcumin — a small trial; benefit unclear mixed evidence
  • Liver detox herbs — anecdotal; some injure the liver anecdotal / traditional

ICD codes