PSC-IBD and Me: The Road to My Liver Transplant

PSC-IBD and Me: The Road to My Liver Transplant
Last week, I celebrated year three of my second birthday, otherwise known as the anniversary of my liver transplant. I usually celebrate with my husband and family, but this year I had outpatient surgery to place a stent and balloons in my biliary duct to open any narrowing and prevent future strictures. My transplant and gastroenterology teams hope the procedure lowers my liver enzymes back to normal levels. They also want to confirm that the autoimmune disease, primary sclerosing cholangitis (PSC), that led to my needing a liver transplant hasn’t returned. What is primary sclerosing cholangitis? Primary sclerosing cholangitis is an autoimmune liver disease that affects the bile ducts connecting the liver to the small intestine. Recurring inflammation of the bile ducts forms scar tissue that eventually causes the ducts to narrow and harden. These strictures impede the flow of bile out of the liver. As bile builds up, cirrhosis (liver scarring) occurs. PSC is incurable, but a patient can survive many years until cirrhosis completely damages the liver. I lived with PSC for 20 years after my diagnosis until I needed a liver transplant. Inflammatory bowel disease and primary sclerosing cholangitis Doctors often see PSC and inflammatory bowel disease (IBD) as comorbidities, although a patient can have one without the other. When occurring together, the condition is called PSC-IBD. A higher percentage of PSC-IBD patients have ulcerative colitis. I’m in the minority of patients with Crohn’s. In addition to being at risk for liver cancer, PSC-IBD patients are at a higher risk for colon cancer as well. PSC-IBD symptoms Some PSC symptoms, such as fatigue and unexplained weight loss, are similar to IBD symptoms. Because PSC is a progressive disease, a patient may n
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