Symptoms & Causes of Primary Sclerosing Cholangitis

What are the symptoms of PSC?

Symptoms of PSC include itchy skin.

Symptoms of primary sclerosing cholangitis (PSC) may include

• pain in the abdomen, or belly
• itchy skin
• diarrhea
• yellowish color of the whites of the eyes and skin, called jaundice
• feeling tired or weak
• fever

PSC may lead to a bile duct infection. Symptoms of a bile duct infection include

• chills
• fever
• new or worsening jaundice
• pain in the upper right side of the abdomen

As the disease gets worse, you may develop cirrhosis. Symptoms of cirrhosis may include

• swelling of the abdomen from a buildup of fluid, called ascites
• confusion or difficulty thinking caused by a buildup of toxins in the brain, called hepatic encephalopathy
• gastrointestinal bleeding caused when enlarged veins—called varices—burst in the esophagus, stomach, or intestines
• other symptoms of cirrhosis, such as edema, jaundice, and weight loss

Because PSC gets worse slowly, you can have the disease for years before you have any symptoms. Many people have no symptoms when they are first diagnosed with PSC.

What causes PSC?

Experts aren’t sure what causes PSC. Studies suggest that several factors may play a role, including

• genes
• immune system problems
• changes in the bacteria in the digestive tract, also called gut flora or the gut microbiome
• bile duct injury caused by bile acids