For unspecified reasons, the bile ducts can become inflamed with subsequent narrowing, which leads to chronic bile congestion. This phenomenon, primary sclerosing cholangitis, is conditionally considered an autoimmune disease, as it is often accompanied by pathologies such as diabetes mellitus, ulcerative colitis , thyroiditis.
Symptoms of primary sclerosing cholangitis
Identify the described syndrome in the early stages is almost impossible, since it progresses for a long time without visible signs. The clinical picture is manifested even during the development of cirrhosis of the liver or portal hypertension:
- increased fatigue;
- itching;
- decreased body weight;
- pain and heaviness in the right hypochondrium;
- periodic yellowing of the skin (transitory jaundice);
- deterioration of appetite;
- rarely - a fever.
Diagnosis of primary sclerosing cholangitis
Confirmation of suspicion of the disease in question, in addition to the collection of history and clinical examination, is carried out with the help of the following instrumental and laboratory studies:
- biochemical, immunological analysis of blood;
- cholangiography;
- liver biopsy;
- duodenal sounding;
- elastography of the liver;
- retrograde pancreatocholangiography;
- FEGDS.
Treatment of primary sclerosing cholangitis
Completely cure pathology is impossible, drug therapy is aimed at slowing the progression of cholangitis and improving the patient's condition. It includes the following drugs:
- antispasmodics;
- glucocorticosteroid hormones;
- immunosuppressors;
- antifibrogenic agents;
- digestive enzymes;
- hepatoprotectors ;
- drugs based on ursodeoxycholic acid.
In addition, antihistamines may be recommended to relieve pruritus.
In case of blockage of the bile ducts and ineffectiveness of conservative treatment, a surgical operation for liver transplantation is prescribed.