Primary sclerosing cholangitis (PSC)

Primary sclerosing cholangitis affects the bile ducts inside and outside the liver. Its underlying cause is not fully understood, and researchers regard it as an immune-mediated disease based on a strong immunogenetic background. Chronic inflammation of the bile duct lining is thought to lead to fibrosis and progressive narrowing of the ducts, which can slow the flow of bile and, over years, contribute to cirrhosis.

It is closely linked with inflammatory bowel disease, most often ulcerative colitis, with an association reported in up to 88 percent of people who have PSC in some study populations. A systematic review of population-based studies found incidence and prevalence rates that vary considerably by geographic region, and more recent data suggest diagnosed incidence has risen over recent decades. Unlike many autoimmune liver conditions, PSC most often affects middle-aged men.

Common signs

Many people have no symptoms early and are found through abnormal liver blood tests. Over time, fatigue, itching, right-sided abdominal discomfort, and episodes of fever or chills (sometimes from bile duct infection) can appear, along with yellowing of the skin or eyes and weight loss as the condition advances.

This is a plain-language summary for orientation, not a diagnosis. Mechanisms are described as current understanding, not settled fact. Work with your own clinician for your care.