Primary Sclerosing Cholangitis: Causes, Symptoms, and Treatment Options

When your primary sclerosing cholangitis, a chronic liver disease that causes inflammation and scarring of the bile ducts. It's often linked to autoimmune conditions and rarely shows up alone—most people with it also have inflammatory bowel disease, especially ulcerative colitis. Unlike regular liver damage from alcohol or fat, this one creeps in slowly, silently, and it doesn’t always cause obvious symptoms until it’s advanced.

Think of your bile ducts as the plumbing system for your liver. They carry bile, a fluid that helps digest fats, from your liver to your small intestine. In primary sclerosing cholangitis, those ducts get inflamed, scarred, and narrowed. Over time, bile builds up in the liver, poisoning liver cells and leading to cirrhosis. It’s not caused by drinking too much, and it’s not contagious. It’s an immune system mistake—your body attacks its own bile ducts. About 70% of people diagnosed with it also have ulcerative colitis, which tells doctors this isn’t just a liver problem—it’s part of a bigger autoimmune puzzle.

There’s no cure yet, but managing it means watching for complications like infections, liver failure, or even bile duct cancer. Common signs include itching, fatigue, yellowing skin (jaundice), and pain in the upper right abdomen. Blood tests can spot abnormal liver enzymes, and an MRI called an MRCP is the best way to see the damaged ducts. Some patients get antibiotics for recurring infections, others need medications to ease itching. Ursodeoxycholic acid is often prescribed, though it doesn’t stop the disease—just helps manage symptoms. For those who reach end-stage liver damage, a transplant is the only option that offers long-term survival.

What’s tricky is that this condition doesn’t follow a clear timeline. One person might live 20 years with mild symptoms; another might decline fast. That’s why regular monitoring is key. Doctors track liver function, screen for cancer, and adjust care based on how the disease moves. There’s no magic pill, but staying informed helps you catch problems early and avoid unnecessary stress.

Below, you’ll find real-world guides on managing liver health, understanding autoimmune triggers, and navigating treatments that actually make a difference—whether you’re newly diagnosed or helping someone who is. These aren’t generic overviews. They’re practical, tested insights from people living with similar conditions and the doctors who treat them.