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</div><div><span>Sclerosing cholangitis</span></div></div>
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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">Sclerosing cholangitis</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Sclerosing cholangitis refers to swelling (inflammation), scarring, and destruction of the <a test="test" href="./002237.htm">bile</a> ducts inside and outside of the liver.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>The cause of this condition is unknown in most cases.</p><p>The disease may be seen in people who have:</p><ul><li>Inflammatory bowel disease (IBD) such as <a test="test" href="./000250.htm">ulcerative colitis</a> and <a test="test" href="./000249.htm">Crohn disease</a><br/></li><li><a test="test" href="./000816.htm">Autoimmune disorders</a></li><li><a test="test" href="./000221.htm">Chronic pancreatitis</a> (inflamed pancreas)</li><li><a test="test" href="./000076.htm">Sarcoidosis</a> (a disease that causes inflammation in various parts of the body)</li></ul><p>Genetic factors may also be responsible. Sclerosing cholangitis occurs more often in men than women. This disorder is rare in children.</p><p>Sclerosing cholangitis may also be caused by:</p><ul><li><a test="test" href="./000274.htm">Choledocholithiasis</a> (gallstones in the bile duct)</li><li>Infections in the liver, gallbladder, and bile ducts</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>The first symptoms are usually:</p><ul><li>Fatigue</li><li>Itching</li><li>Yellowing of the skin and eyes (jaundice) </li></ul><p>However, some people have no symptoms.</p><p>Other symptoms may include:</p><ul><li><a test="test" href="./003275.htm">Enlarged liver</a></li><li><a test="test" href="./003276.htm">Enlarged spleen</a></li><li>Loss of appetite and weight loss</li><li>Repeat episodes of <a test="test" href="./000290.htm">cholangitis</a> (an infection of the bile duct that causes fever, jaundice and pain in the right upper abdomen)</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>Even though some people do not have symptoms, blood tests shows that they have abnormal liver function. Your health care provider will look for:</p><ul><li>Diseases that cause similar problems</li><li>Diseases that often occur with this condition (especially IBD)</li><li>Gallstones</li></ul><p>Tests that show cholangitis include:</p><ul><li><a test="test" href="./003789.htm">Abdominal CT scan</a></li><li><a test="test" href="./003777.htm">Abdominal ultrasound</a></li><li><a test="test" href="./007479.htm">Endoscopic retrograde cholangiopancreatography</a> (ERCP)</li><li><a test="test" href="./003895.htm">Liver biopsy</a></li><li>Magnetic resonance cholangiopancreatography (MRCP)</li><li>Percutaneous transhepatic cholangiogram (<a test="test" href="./003820.htm">PTC</a>)</li><li>Blood tests for liver enzymes (<a test="test" href="./003436.htm">liver function tests</a>)</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>Medicines that may be used include:</p><ul><li>Cholestyramine (such as Prevalite) to treat itching</li><li>Ursodeoxycholic acid (ursodiol) to improve liver function</li><li>Fat-soluble vitamins (D, E, A, K) to replace what is lost from the disease itself</li><li>Antibiotics to treat infections in the bile ducts</li></ul><p>These surgical procedures may be done:</p><ul><li>Inserting a long, thin tube with a balloon at the end to open up narrowing (<a test="test" href="./002360.htm">endoscopic</a> balloon dilation of strictures)</li><li>Placement of a drain or tube for major narrowing (strictures) of bile ducts</li><li><a test="test" href="./007381.htm">Proctocolectomy</a> (removal of colon and rectum, for those who have both ulcerative colitis and sclerosing cholangitis) does not affect the progression of primary sclerosing cholangitis (PSC)</li><li>Liver transplant</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>How well people do varies. The disease tends to get worse over time. Sometimes people develop:</p><ul><li><a test="test" href="./000286.htm">Ascites</a> (buildup of fluid in the space between the lining of the abdomen and abdominal organs) and <a test="test" href="./000268.htm">varices</a> in the esophagus or stomach (enlarged veins)</li><li>Biliary <a test="test" href="./000255.htm">cirrhosis</a> (liver scarring due to inflammation of the bile ducts)</li><li>Liver failure</li><li>Persistent jaundice</li></ul><p>Some people develop infections of the bile ducts that keep returning.</p><p>People with this condition have a high risk for developing cancer of the bile ducts (cholangiocarcinoma). They should be checked regularly with a liver imaging test and blood tests. People who also have IBD may have an increased risk for developing cancer of the colon or rectum and should have periodic colonoscopy.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Complications may include:</p><ul><li><a test="test" href="./000268.htm">Bleeding esophageal varices</a></li><li>Cancer in the bile ducts (<a test="test" href="./000291.htm">cholangiocarcinoma</a>)</li><li><a test="test" href="./000255.htm">Cirrhosis</a> and liver failure</li><li>Infection of the biliary system (<a test="test" href="./000290.htm">cholangitis</a>)</li><li>Narrowing of the bile ducts</li><li>Vitamin deficiencies </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Primary sclerosing cholangitis; PSC </p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/1090t.jpg" alt="Digestive system" title="Digestive system" class="side-img"/><a href="../imagepages/1090.htm">Digestive system</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/8794t.jpg" alt="Bile pathway" title="Bile pathway" class="side-img"/><a href="../imagepages/8794.htm">Bile pathway</a></li>
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Ahrendt GM, Ahrendt SA. Gallbladder and biliary tree: Management of primary sclerosing cholangitis. In: Cameron AM, Cameron JL, eds. <em>Current Surgical Therapy</em>. 14th ed. Philadelphia, PA: Elsevier; 2023:457-538.</p><p>Bowlus C, Assis DN, Goldberg D. Primary and secondary sclerosing cholangitis. In: Sanyal AJ, Boyer TD, Lindor KD, Terrault NA, eds. <em>Zakim and Boyer's Hepatology</em>. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 43.</p><p>Levy C, Bowlus CL. Primary and secondary sclerosing cholangitis. In: Feldman M, Friedman LS, Brandt LJ, eds. <em>Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management</em>. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 68.</p></div></div></section>
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