When you hear PSC, Primary Sclerosing Cholangitis is a chronic liver disease that causes inflammation and scarring of the bile ducts. Also known as primary sclerosing cholangitis, it’s not just another liver issue—it’s a slow, silent condition that can lead to cirrhosis, liver failure, and even bile duct cancer if left unmanaged. Unlike hepatitis or fatty liver disease, PSC doesn’t come from alcohol, obesity, or viruses. It’s an autoimmune disorder, meaning your immune system mistakenly attacks the tubes that carry bile out of your liver. This damage builds up over years, often without symptoms at first, which is why so many people are diagnosed only after routine blood tests show abnormal liver numbers.
PSC rarely shows up alone. It’s closely tied to inflammatory bowel disease, a group of conditions including ulcerative colitis and Crohn’s disease that cause chronic gut inflammation. In fact, about 70% of PSC patients also have ulcerative colitis. That’s why doctors often check for PSC in people already diagnosed with IBD, especially if they have unexplained fatigue, itching, or rising liver enzymes. The connection isn’t fully understood, but it’s strong enough that managing one often means watching the other. And while there’s no cure yet, treatments focus on slowing damage, relieving symptoms like itching and fatigue, and catching complications early—like bile duct cancer, a rare but serious risk for people with long-standing PSC.
What makes PSC tricky is how unpredictable it is. Two people with the same diagnosis can have wildly different progressions—one might live decades with minimal issues, while another sees rapid decline. That’s why regular monitoring with blood tests, MRIs, and sometimes liver biopsies is key. Newer drugs are being tested, but right now, the most effective tool is early detection and careful management. If you’ve been told you have PSC, or if you have IBD and your liver numbers are off, you’re not alone. Thousands are walking this path, and the more you know about how it works, the better you can protect yourself.
The posts below cover everything from how PSC shows up in bloodwork to what it really means when your doctor mentions a liver transplant. You’ll find real stories about managing itching without steroids, why vitamin D levels matter so much, and how some patients are using diet and lifestyle to support their liver—even when there’s no magic bullet. These aren’t theoretical guides. They’re practical, evidence-based insights from people living with PSC and the doctors who treat them.
Autoimmune overlap syndromes like AIH-PBC occur when the immune system attacks the liver in multiple ways at once. Learn how PBC, PSC, and AIH combine, why diagnosis is tricky, and what treatments actually work.
