Sclerosing cholangitis: what it is, symptoms, diagnosis and treatment

Sclerosing cholangitis is a rare disease more frequent in men characterized by liver involvement due to inflammation and fibrosis caused by the narrowing of the channels through which bile passes, which is a fundamental substance for the digestive process. This situation happens, most of the time, as a result of autoimmune diseases and inflammatory bowel diseases, such as ulcerative colitis.

Most cases of sclerosing cholangitis do not lead to the appearance of symptoms, being diagnosed only through imaging and laboratory tests, which identify changes in the liver. It is important that the diagnosis is made as soon as possible, as cholangitis can bring several health complications when not treated quickly and properly.

Signs and symptoms of sclerosing cholangitis

Most people with sclerosing cholangitis have no symptoms and are identified by exams. On the other hand, in some cases signs and symptoms of cholangitis can be identified, such as:

• Excessive tiredness; Itchy body; Yellow skin and eyes; There may be chills fever and abdominal pain; Muscle weakness; Weight loss; Enlarged liver; Enlarged spleen; Emergence of xanthomas, which are skin lesions consisting of fats; Pruritus.

In some cases, there may also be diarrhea, abdominal pain and the presence of blood or mucus in the stool. In the presence of these symptoms, especially if they are recurrent or constant, it is important to consult the general practitioner or hepatologist so that tests can be carried out and appropriate treatment can be started.

Types of sclerosing cholangitis

Sclerosing cholangitis can be classified as acute or chronic, being observed in acute infection of the bile ducts both inside and outside the liver and in chronic form, constant accumulation of bile in the liver that results in cirrhosis and increases the chances of cancer.

This situation can still be classified into primary or secondary sclerosing cholangitis, where in the primary it means that the problem started even in the biliary tract, while in the secondary form, the disease is due to another problem such as a tumor or a trauma in this region.

Main causes

The causes of sclerosing cholangitis are not yet well established, and may be due to infection by viruses or bacteria, be the result of autoimmune diseases or be related to genetic factors. It is also believed that sclerosing cholangitis is related to ulcerative colitis, in which people with this type of inflammatory bowel disease were at higher risk for developing cholangitis.

Diagnosis of sclerosing cholangitis

The diagnosis is made by the general practitioner or hepatologist through laboratory and imaging tests. Usually, the initial diagnosis is made through the results of tests that assess liver function, with changes in the amount of liver enzymes, such as TGO and TGP, in addition to an increase in alkaline phosphatase and gamma-GT. In some cases, the doctor may also request the performance of protein electrophoresis, in which increased levels of gamma globulins, especially IgG, can be seen.

To confirm the diagnosis, the doctor may request a liver biopsy and cholangiography, which is a diagnostic test that aims to assess the bile ducts and check the path from the bile from the liver to the duodenum, making it possible to view any changes. Understand how cholangiography is done.

How treatment should be done

The treatment for sclerosing cholangitis is done according to the severity of the cholangitis, and the use of the medication that contains ursodeoxycholic acid, commercially known as Ursacol, may be indicated by the doctor, in addition to endoscopic treatment in order to reduce the degree of obstruction and favor the passage of bile. In the most severe cases, the doctor may recommend a liver transplant.

It is important that treatment is started soon after diagnosis to prevent disease progression and result in complications such as cirrhosis of the liver, hypertension and liver failure.