Primary sclerosing cholangitis is a disease that affects the bile ducts of the human body, which are responsible for transporting bile from the liver to the small intestine. This disease causes inflammation that causes scarring of the ducts and damage to the liver.
It is a disease that develops slowly, can lead to biliary cirrhosis, and the only complete cure is a liver transplant, although it can generally be controlled with treatment. It is more common in men than in women and is usually diagnosed between the ages of 30 and 50.
Causes of primary sclerosing cholangitis
The exact causes have not been identified
Science has not been able to identify 100% of the things that cause primary sclerosing cholangitis. An inappropriate reaction by the immune system to an infectious process can act as an activator of this disease in genetically predisposed people.
Primary sclerosing cholangitis is sometimes linked to inflammatory bowel disease such as ulcerative colitis and Crohn’s disease. It can also appear in patients with chronic pancreatitis and in patients with sarcoidosis. That is why when it is discovered that a patient has the disease, they are also studied to see if they have inflammatory bowel disease. In these cases, early detection is important because colon cancer can occur.
It is important to carry out the treatment as soon as possible to avoid other negative effects. Such as the appearance of liver failure, frequent infections, hypertension and even cancerous processes.
Symptoms of primary sclerosing cholangitis
Feeling tired
Primary sclerosing cholangitis causes a feeling of fatigue and continuous itching at the beginning of the disease, but it is not accompanied by other clear symptoms that help identify the existence of the disease. As time goes by, more obvious signs do appear, such as pain in the upper area of the right side of the abdomen, fever, night sweats, chills, dizziness and a yellowish color to the skin and/or eyes (jaundice). There may also be an enlarged liver and/or spleen and weight loss.
Complications of primary sclerosing cholangitis can be:
– Liver failure.
– Repeated infections.
– Hypertension of the portal vein that carries blood flowing from the digestive system to the liver.
– Osteoporosis.
– Colon cancer.
Diagnosis of primary sclerosing cholangitis
Various analyzes
The doctor will need to perform a blood test to know how the liver is functioning. Additionally, you need to study the results of an MRI of the area of the liver and bile ducts. Sometimes X-rays are also used to obtain images of the affected area. And to know the level of involvement, a fairly conclusive test is performing a biopsy to extract liver tissue for analysis.
Endoscopic retrograde cholangiopancreatography (ERCP) may also be performed endoscopically to examine the bile ducts.
Treatment and medication of primary sclerosing cholangitis
Continuous monitoring of liver function
There is no clear treatment with medication and, in fact, the only absolute cure is through liver transplantation. While this is not carried out, the doctor carries out continuous monitoring to see how liver function evolves and recommends certain treatments to alleviate the consequences. For example, he or she may prescribe antibiotics, antihistamines, and medications that bind to bile acids to prevent itching.
To fight against frequent infections, the use of antibiotics is also advisable. Generally, patients with primary sclerosing cholangitis need to take nutritional and vitamin supplements.
Finally, the only method to cure the disease is a transplant to replace the damaged liver with a new one. This process occurs in people who have liver failure.
Prevention of primary sclerosing cholangitis
Healthy habits
Genetic predisposition is key to developing the disease. Therefore, it is difficult to prevent it, but it is advisable to follow healthy lifestyle habits such as following a balanced diet, not smoking or drinking alcohol, and exercising regularly.
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