SCLEROSING CHOLANGITIS
Definition
- Primary sclerosing cholangitis (PSC) is a chronic liver disease characterized by inflammation and fibrosis of the bile ducts.
- It is a progressive disease that can lead to cirrhosis, bile duct cancer, and liver failure.
Types
- Primary sclerosing cholangitis (PSC) is the most common type.
- Secondary sclerosing cholangitis is less common and is often associated with other conditions such as bile duct injuries or infections.
Causes
- The exact cause of PSC is unknown, but it is believed to be an autoimmune disease.
- It is often associated with inflammatory bowel disease (IBD), particularly ulcerative colitis.
- Other potential triggers include genetic factors, environmental factors, and bacterial infections.
Clinical Features
- Recurrent episodes of jaundice and itching
- Abdominal pain
- Weight loss
- Fatigue
- Pale stools
- Dark urine
Investigations
- Liver function tests (LFTs) may be normal or elevated
- Imaging studies such as ultrasound, CT, or MRI may show bile duct narrowing or dilation
- Endoscopic retrograde cholangiopancreatography (ERCP) is used to visualize the bile ducts and take biopsies
- Cholangiography may show characteristic "beading" of the bile ducts
Complications
- Cirrhosis
- Bile duct cancer
- Cholangiocarcinoma
- Liver failure
- Intraductal papillary mucinous neoplasms (IPMNs)
Management
- There is no cure for PSC, but treatment aims to manage symptoms and prevent complications
- Medications such as ursodeoxycholic acid (UDCA) may help improve liver function and slow disease progression
- Endoscopic retrograde cholangiopancreatography (ERCP) may be used to dilate or stent narrowed bile ducts
- Liver transplantation may be necessary in advanced cases
Treatment
- No specific treatment is available for PSC, but management of symptoms and prevention of complications are key
- Surgical interventions such as liver resection or bile duct surgery may be necessary in some cases
Homoeopathic Therapeutic Medicines
- Lycopodium clavatum: For weight loss, abdominal pain, and itching
- Chelidonium majus: For jaundice, itching, and abdominal pain
- Nux vomica: For abdominal pain, nausea, and vomiting
- Phosphorus: For liver function tests (LFTs) abnormalities and abdominal pain
- Calcarea carbonica: For fatigue, weight loss, and abdominal pain
- Graphites: For weight loss, abdominal pain, and itching