Facts about Primary Sclerosing Cholangitis

Dr. Michell Shiffman of Bon Secours' Liver Institute of Virginia

Dr. Michell Shiffman of Bon Secours' Liver Institute of Virginia

Primary Sclerosing Cholangitis (PSC) is a disease in which the immune system damages the large bile ducts within the liver.  Bile ducts are tubes within the liver which drain bile into the gallbladder and intestine. In this disease the large bile ducts develop strictures and narrowing which prevent bile from flowing into the gallbladder and intestine.  This causes bile to “back-up” into the liver.  This damages liver cells and leads to increasing scaring within the liver and eventually cirrhosis.  This process takes approximately 10-20 years.

PSC is not contagious. Patients inherit a genetic tendency to develop this disease and many persons with PSC have family members with other immune disorders.  Patients with PSC frequently have another immune disorder, Ulcerative Colitis or Crohns Disease.

Many persons with PSC are asymptomatic. However, as the disease progresses and the strictures within the bile ducts become more severe many persons develop itching, jaundice and fatigue.

PSC causes the blood liver enzyme tests to be abnormal. A specific antibody may also be present in the blood of patients with PSC. Patients with PSC may also have elevated blood cholesterol.

Unfortunately, no treatment has been shown to be effective for PSC. Although URSO is effective in another bile duct disease, PBC, several studies have shown that USO is not effective in PSC. In fact, a recent study has demonstrated that URSO may make patients with PSC worse. The only effective treatment for patients with advanced PSC is liver transplant. Patients with PSC should therefore be monitored at regular intervals and offered liver transplant when the disease has progressed to a certain point.

The most severe complication of PSC is bile duct cancer, also called cholangiocarcinoma. It is extremely difficult to identify when bile duct cancer has developed in patients with PSC. Screening tests to identify bile duct cancer early are not very effective. Unfortunately, there is also no good treatment for bile duct cancer. Chemotherapy, radiation or surgery has not been shown to improve survival in patients with bile duct cancer.

Dr. Shiffman and the staff at the Liver Institute of Virginia have extensive experience in the evaluation and management of patients with PSC and can help educate patients about this disease and when a liver transplant should be considered.

This entry was posted in Bon Secours News, Bon Secours Specialties, Featured Health News, General News, Health News & Information, Liver Health and tagged , , , , , , , , on by .

About Dr.MLShiffman

Dr. Mitchell Shiffman is the Bon Secours expert on liver disease and liver treatments for Virginia. Prior to joining Bon Secours, Dr. Shiffman was a professor of Medicine at Virginia Commonwealth University (VCU) in Richmond, VA. He was the Chief of the Hepatology Section and Medical Director of the Liver Transplant Program at the VCU Medical Center from 1989 until 2009. During his 20 years at the VCU Medical Center Dr. Shiffman built and directed one of the most respected and productive hepatology programs in the United States. Dr. Shiffman is recognized as one of the world’s leaders in the field of Hepatology. His particular area of research is viral hepatitis. He has been involved with and/or directed numerous clinical trials to develop new and better treatments for viral hepatitis B and C. Dr. Shiffman is a regular speaker on the treatment of viral hepatitis, the management of various liver disorders, and issues related to liver transplantation at regional, national and international society meetings. He has published over 200 articles in medical journals related to the treatment of liver diseases and has edited two books on this topic. In addition, he has contributed to various HCV educational resources including an HCV educational kit. Dr. Shiffman is also a widely recognized expert consultant to pharmaceutical companies on the treatment of liver disease. Dr. Shiffman holds a Bachelor of Arts from State University of New York at Buffalo, a Master of Science in physiology from the University of New Mexico School of Medicine in Albuquerque, N.M. and his Doctor of Medicine from State University of New York Upstate Medical Center in Syracuse, N.Y. He completed his internship and residency in internal medicine and fellowship training in gastroenterology and hepatology at the Medical College of Virginia Hospitals in Richmond, VA. Dr. Shiffman is a member of many professional organizations including: the American College of Gastroenterology, American College of Physicians, the American Gastroenterological Association, American Society for the Study of Liver Diseases, American Society of Transplantation, European Association for the Study of the Liver, International Liver Transplantation Society, Richmond Academy of Medicine, Virginia Medical Society and the Virginia Gastrointestinal Society. He was a member of the Board of Trustees with the American College of Gastroenterology from 2003-2009.

Speak Your Mind