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Recognizing the Signs and Symptoms of Primary Sclerosing Cholangitis
Published: Jul 23, 2024
Primary sclerosing cholangitis (PSC) often develops slowly and may not cause noticeable symptoms in its early stages. However, recognizing potential signs is crucial for early diagnosis and management.
Early Symptoms
Many people with PSC are asymptomatic at first, with the condition discovered through routine blood tests. When early symptoms do appear, they're often vague and can include fatigue, mild itching, or discomfort in the upper right part of the abdomen. These symptoms can be easily overlooked or attributed to other causes.
Progressive Symptoms
As PSC advances, more noticeable symptoms may develop. Jaundice, causing yellowing of the skin and eyes, is a key sign. Intense itching (pruritus) can become severe and impact quality of life. Some patients experience unexplained weight loss or develop enlarged blood vessels under the skin (spider angiomas). Darkening of urine and pale-colored stools may also occur.
Complications
PSC can lead to serious complications. Recurrent bacterial cholangitis can cause episodes of fever, chills, and worsening abdominal pain. As liver function declines, symptoms of advanced liver disease may appear, such as fluid accumulation in the abdomen (ascites), confusion due to toxin buildup (hepatic encephalopathy), or bleeding from enlarged veins in the esophagus (varices).
Related Conditions
Given the strong association with inflammatory bowel disease (IBD), many PSC patients also experience digestive symptoms like diarrhea, abdominal pain, or rectal bleeding. PSC also increases the risk of certain cancers, particularly bile duct cancer (cholangiocarcinoma) and colorectal cancer. New or changing symptoms should always be reported to a healthcare provider.
Frequently Asked Questions
Yes, symptoms can fluctuate, with periods of improvement and worsening.
It can cause abdominal discomfort, but severe pain isn't typical.
The rate of progression varies widely between individuals.
Stress may exacerbate some symptoms, but it doesn't cause PSC progression.
Symptoms are generally similar, but children may show growth delays.
Listen to Your Body
While PSC symptoms can be subtle, paying attention to changes in your health and regular check-ups can lead to earlier diagnosis and better outcomes.
References
- Karlsen TH, et al. Primary sclerosing cholangitis - a comprehensive review. J Hepatol. 2017;67(6):1298-1323.
- Eaton JE, et al. Pathogenesis of primary sclerosing cholangitis and advances in diagnosis and management. Gastroenterology. 2013;145(3):521-536.
- Lindor KD, et al. ACG Clinical Guideline: Primary Sclerosing Cholangitis. Am J Gastroenterol. 2015;110(5):646-659.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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