PSC: What It Is, How It Affects You, and What Treatments Help

When you hear PSC, Primary Sclerosing Cholangitis, a chronic liver disease that slowly destroys the bile ducts. Also known as primary sclerosing cholangitis, it’s not just another liver issue—it’s a condition that quietly builds up damage until symptoms like fatigue, itching, or jaundice force you to pay attention. PSC isn’t caused by drinking too much or poor diet. It’s an autoimmune disorder where your immune system attacks the tubes that carry bile out of your liver. Over time, those ducts scar, narrow, and block bile flow, leading to liver damage, infection, and sometimes cirrhosis.

PSC often shows up alongside inflammatory bowel disease, especially ulcerative colitis, which affects the colon and rectum. About 70% of people with PSC also have IBD, and the two conditions seem to feed off each other. That’s why doctors check your gut when diagnosing liver problems—and vice versa. It’s also why treatments for PSC don’t always focus on the liver alone. Managing gut inflammation can slow liver damage, even if there’s no cure yet.

There’s no magic pill for PSC, but ursodeoxycholic acid, a bile acid that helps move bile out of the liver. is commonly used to ease symptoms and delay progression. Some patients respond well; others don’t. New drugs are being tested, like obeticholic acid and fibrates, but none are approved yet. What does work is catching complications early—like bile duct infections, bone loss from poor nutrient absorption, or rising liver enzymes. Regular scans, blood tests, and monitoring for liver cancer are non-negotiable.

People with PSC often feel forgotten. It’s rare, it’s slow, and most doctors won’t see more than a few cases in their career. But you’re not alone. The posts below cover real stories and science: how PSC affects sleep, why itching gets worse at night, how vitamin D and calcium become critical, and what happens when your liver starts to fail. You’ll find practical advice on managing fatigue, dealing with itching without scratching your skin raw, and how to talk to your doctor when tests look normal but you still feel terrible. These aren’t generic tips—they’re from people living with PSC, and the doctors who’ve learned how to help them.