From the Guidelines
Doctors with PSC are typically managed by a multidisciplinary team of healthcare professionals, including hepatologists, gastroenterologists, and surgeons, who work together to provide comprehensive care and management of the disease. The management of PSC involves a combination of medical and surgical interventions, with the goal of alleviating symptoms, preventing complications, and improving quality of life. According to the EASL clinical practice guidelines on sclerosing cholangitis 1, the management of PSC should be individualized and based on the severity of the disease, the presence of complications, and the patient's overall health status.
Some of the key recommendations for the management of PSC include:
- Regular monitoring with liver function tests, imaging studies, and endoscopic procedures to assess disease progression and detect complications early 1
- Use of medications such as ursodeoxycholic acid (UDCA) to improve liver function and reduce symptoms 1
- Antibiotics for cholangitis episodes and treatments for complications like pruritus and fat-soluble vitamin deficiencies 1
- Endoscopic retrograde cholangiopancreatography (ERCP) for diagnostic and therapeutic purposes, including the removal of bile duct stones and the dilation of strictures 1
- Liver transplantation for patients with advanced disease or those who have developed complications such as liver failure or cholangiocarcinoma 1
It is also important to note that doctors with PSC may need to make accommodations as their disease progresses, and some may eventually require liver transplantation if their condition advances to end-stage liver disease. However, with proper management and care, many doctors with PSC are able to continue practicing medicine effectively and maintaining a good quality of life. As stated in the EASL clinical practice guidelines on sclerosing cholangitis 1, clinicians should explore and assess quality of life issues in people with PSC as part of routine standard of care.
From the Research
Doctors Specializing in PSC
There is no specific information available on individual doctors specializing in Primary Sclerosing Cholangitis (PSC) in the provided studies. However, the following are some key points related to the management and treatment of PSC:
- PSC is a chronic biliary inflammation associated with periductular fibrosis of the intrahepatic and extrahepatic bile ducts, leading to strictures, bacterial cholangitis, decompensated liver disease, and need for liver transplantation 2.
- The management of PSC is mainly focused on treatment of symptoms and addressing complications, with no effective medical therapy for halting disease progression identified 3.
- Current management of patients with PSC is centered on endoscopic therapy of biliary strictures, management of complications of chronic cholestasis and of progressive liver disease, and close clinical monitoring for development of cholangiocarcinoma, as well as for timely referral for liver transplantation 4.
Specializations
Doctors who may be involved in the management and treatment of PSC include:
- Gastroenterologists: specializing in the diagnosis and treatment of digestive system disorders, including liver diseases like PSC 2, 3, 4.
- Hepatologists: specializing in the diagnosis and treatment of liver diseases, including PSC 2, 3, 4.
- Surgeons: specializing in liver transplantation and other surgical procedures related to PSC 2, 3.
Research and Development
Several novel therapeutic strategies are in various stages of development for the treatment of PSC, including:
- Apical sodium-dependent bile acid transporter and ileal bile acid transporter inhibitors 2.
- Integrin inhibitors, peroxisome proliferator-activated receptor agonists, CCL24 blockers, recombinant FGF19, CCR2/CCR5 inhibitors, farnesoid X receptor bile acid receptor agonists, and nor-ursodeoxycholic acid 2.
- Manipulation of the gut microbiome, including faecal microbiota transplantation 2.