From the Guidelines
Yes, patients with Primary Sclerosing Cholangitis (PSC) can experience abdominal pain, specifically right upper quadrant abdominal pain, which may be present in some patients, particularly those with elevated serum liver tests in a cholestatic pattern 1. This pain is a symptom that may be accompanied by other symptoms such as jaundice and/or pruritus. According to the EASL clinical practice guidelines on sclerosing cholangitis, most patients with PSC are asymptomatic, but some may present with abdominal pain, which can be a significant symptom in some cases 1. Some key points to consider in patients with PSC and abdominal pain include:
- The presence of abdominal pain, particularly right upper quadrant pain, should raise suspicion for PSC, especially in patients with concomitant inflammatory bowel disease (IBD) 1.
- Abdominal pain in PSC patients can be a symptom of acute cholangitis, which is a serious infection of the bile ducts requiring immediate medical attention, antibiotics, and possibly endoscopic intervention 1.
- The diagnosis of PSC should be made in the presence of typical findings of sclerosing cholangitis on high-quality cholangiography, such as magnetic resonance cholangiopancreaticography (MRCP), and after exclusion of secondary causes 1.
- Patients with PSC should be carefully evaluated for complications of liver disease, including evidence of portal hypertension, and monitored for disease progression and potential development of cholangitis 1.
From the Research
Symptoms of Primary Sclerosing Cholangitis (PSC)
- Abdominal pain is a common symptom of PSC, as stated in the study 2
- Other symptoms of PSC include pruritus, jaundice, and fatigue 2
- Patients with PSC often experience upper and lower abdominal pain, as seen in a pediatric case study 3
Association with Inflammatory Bowel Disease (IBD)
- PSC is often associated with IBD, and patients with IBD are at a higher risk of developing PSC 2, 4, 5
- The presence of IBD can exacerbate the symptoms of PSC, including abdominal pain 3
Treatment and Management of PSC
- There is no effective medical therapy for halting the progression of PSC, and management is mainly focused on treating symptoms and addressing complications 2, 4
- Ursodeoxycholic acid (UDCA) has been shown to improve symptoms and biochemical markers in some patients with PSC, but its effectiveness is still being studied 3, 6