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Treatments and drugs
By Mayo Clinic staffTreatments for primary sclerosing cholangitis focus on reducing signs and symptoms of the disease as it progresses. Primary sclerosing cholangitis progresses slowly, but it usually ends in liver failure and the need for a liver transplant. Many medications have been studied in people with primary sclerosing cholangitis, but so far none has been proved to slow or reverse the liver damage associated with this disease.
Treatment for itching
Medications that may help control itching include:
- Antihistamines, such as diphenhydramine (Benadryl, others)
- Bile-acid-binding drugs, such as cholestyramine (Locholest, Questran, others)
Treatment for infections
Bacterial infections can occur frequently in people with primary sclerosing cholangitis. Antibiotics may be prescribed to treat an infection. If you've had repeated infections, your doctor may recommend antibiotics before procedures that are likely to cause infection, such as endoscopic procedures or surgery.
Treatment for malnutrition
Primary sclerosing cholangitis makes it difficult for your body to absorb certain vitamins. Even though you may eat a healthy diet, you may find that you can't get all the nutrients you need. Your doctor may recommend vitamin supplements that you take as tablets or that you receive as an infusion through a vein in your arm.
Treatment for bile duct blockages
Blockages that occur in your bile ducts can be treated with:
- Balloon dilation and stent placement. These procedures can open blockages in the larger bile ducts. Balloon dilation is a procedure in which your doctor runs a slender tube with an inflatable balloon at its tip (balloon catheter) through an endoscope and into a blocked bile duct. Once the balloon catheter is in place, the balloon is inflated. Small plastic tubes called stents may be placed in bile ducts to keep them open.
- Bile duct surgery. In certain situations, blockages in bile ducts may need to be removed surgically. After removing a blockage, the surgeon connects the remaining portions of bile duct so that bile can still flow through the duct.
Liver transplant
A liver transplant is the only treatment known to cure primary sclerosing cholangitis. During a liver transplant, surgeons remove your diseased liver and replace it with a healthy liver from a donor. Liver transplant is reserved for people with liver failure or other severe complications of primary sclerosing cholangitis. Though uncommon, it's possible for primary sclerosing cholangitis to recur after a liver transplant.
- Ross AS, et al. Sclerosing cholangitis and recurrent pyogenic cholangitis. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&isbn=978-1-4160-6189-2&about=true&uniqId=229935664-2192. Accessed March 3, 2011.
- Diagnosis and management of primary sclerosing cholangitis. Alexandria, Va.: American Association for the Study of Liver Diseases. http://www.aasld.org/practiceguidelines/Documents/Practice%20Guidelines/PSC_2-2010.pdf. Accessed March 3, 2011.
- Lopez MJ, et al. Primary sclerosing cholangitis and primary biliary cirrhosis. The American College of Gastroenterology. http://www.acg.gi.org/patients/gihealth/sclerosing.asp. Accessed March 3, 2011.
- Primary sclerosing cholangitis. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/primarysclerosingcholangitis/index.htm. Accessed March 3, 2011.
- Liver health. American Liver Foundation. http://www.liverfoundation.org/abouttheliver/liverhealth/. Accessed March 3, 2011.
- Mendes F, et al. Primary and sclerosing cholangitis: Overview and update. Nature Reviews Gastroenterology & Hepatology. 2010;7:611.
- Rosenthal TC, et al. Fatigue: An overview. American Family Physician. 2008;78:1173.
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