Are PSC and ulcerative colitis related?

Researchers have established a link between primary sclerosing cholangitis (PSC) and ulcerative colitis (UC). PSC is a rare disease that causes scarring in the bile ducts of the liver.

Scarring can ultimately lead to liver damage and potentially failure in some severe cases. Most people with PSC also have UC.

Although doctors don’t know exactly what causes PSC, they have established UC as a risk factor. Keep reading to learn more about the potential links between these two conditions.

An estimated 60-80% of people with PSC have UC, while PSC affects approximately 5% of people with UC. Like PSC, UC has no known cause or causes. But both conditions are the result of inflammation.

Doctors know that people designated male at birth tend to have PSC at higher rates. They also believe that there is a strong genetic component to both diseases, so having a family history may then increase the risk of getting both diseases.

In addition to these risk factors, there are some theories that UC may increase a person’s likelihood of developing PSC. Researchers believe that UC may allow bacteria to enter the liver circulation, which may lead to inflammation, but. research has not revealed the specific effects of UC on the liver.

There are several treatment approaches that can change when you have both UC and PSC. These include the following.


The results of several studies suggest that people with both PSC and UC generally have milder UC symptoms than those without. However, the risk of colon cancer is higher in people with both diseases. Therefore, this may change the recommended frequency of colonoscopies.


People with UC and PSC are less likely to need medications that doctors usually prescribe to treat more severe cases of UC. Examples include anti-tumor necrosis factor alpha (anti-TNFα) therapy and corticosteroids. But some people with both conditions may require treatment with these drugs.


If UC gets worse and causes significant damage, a doctor may recommend surgery to remove the diseased part of the colon. This surgical approach may require an ileostomy, a procedure in which a surgeon will route part of the intestine to the abdominal wall. This gives the body time to heal and recover from significant inflammation.

After the healing time, a doctor can perform reconstructive surgery. This is a procedure in which they reverse the ileostomy so that your stool comes out through the rectum again. Studies of reconstructive surgeries for UC and PSC indicate no higher risk of failure compared to surgeries for people who do not have PSC.

People with UC are at greater risk for PSC than for Crohn’s disease, another type of inflammatory bowel disease. Researchers have theories about why people more frequently experience these two conditions together, but they haven’t established a specific link.

If both conditions have been diagnosed, it is important to seek help. From participating in research studies to talking with others, support is available to help you have a better quality of life.

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