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Primary Sclerosing Cholangitis
Experience expert care for Primary Sclerosing Cholangitis in Houston with Dr. Scott at GastroDoxs. Offering advanced diagnostics, personalized treatment plans, minimally invasive procedures, and lifestyle guidance, Dr. Scott helps you manage PSC effectively and improve liver health with compassionate support.
Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.
Common Causes and Risk Factors
Unknown exact cause-likely autoimmune
Associated with inflammatory bowel disease (especially ulcerative colitis)
Linked to Crohn's disease
Most often affects men aged 30-50
Family history of PSC or other autoimmune conditions
Signs and Symptoms
Often none in early stages
Fatigue or general weakness
Itchy skin (pruritus)
Jaundice (yellowing of skin and eyes)
Pain or discomfort in the upper right abdomen
Unexplained weight loss
Fever and chills if bile duct infection develops
How Dr. Scott Diagnoses Primary Sclerosing Cholangitis?
Dr. Scott uses a step-by-step approach:
Medical History and Exam
He reviews your symptoms (itching, jaundice, epigastric discomfort), any history of IBD, autoimmune conditions and family risk factors.
Blood Tests
We check liver enzymes (ALK-P, AST, ALT), bilirubin levels and screen for autoantibodies such as p-ANCA to support the PSC diagnosis.
Imaging Studies
MRCP (Magnetic Resonance Cholangiopancreatography) to non-invasively visualize bile duct narrowing, beading and strictures.
ERCP (Endoscopic Retrograde Cholangiopancreatography) when detailed ductal mapping or stent placement is needed.
Advanced Testing (if needed)
Occasionally a liver biopsy is performed to assess the degree of inflammation and fibrosis when imaging alone is inconclusive.
Treatment
Our Team offers a full range of care for primary sclerosing cholangitis (PSC).
1. Lifestyle and Diet Modifications
Personalized low-fat, well-balanced meal plans
Hydration guidance to support bile flow
Alcohol avoidance and safe over-the-counter medication counseling
2. Medications
Ursodiol (UDCA) to improve bile flow
Fat-soluble vitamins (A, D, E, K) for nutritional support
Bile acid binders or antibiotics to relieve itching
Immune-modulating therapies when indicated
3. Minimally Invasive or Advanced Procedures
ERCP with stent placement to open narrowed ducts
Balloon dilation for ductal strictures
Referral for liver transplant evaluation if disease advances
Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.
Frequently Asked Questions
What's the difference between PSC and PBC?
PSC affects the larger bile ducts both inside and outside the liver, while PBC mainly targets the small bile ducts within the liver. They are distinct autoimmune cholestatic liver diseases.
Can PSC be diagnosed with just a blood test?
No. Blood tests help assess liver function and look for autoantibodies like p-ANCA, but imaging with MRCP or ERCP is required to visualize bile duct changes and confirm the diagnosis.
Is there a cure for PSC?
Currently, there's no cure for PSC. Treatments focus on managing symptoms, improving bile flow, and slowing disease progression. In advanced cases, liver transplantation may be needed.
What are PSC antibodies?
PSC is often associated with autoantibodies such as p-ANCA (perinuclear anti-neutrophil cytoplasmic antibodies). Their presence supports the diagnosis but is not exclusive to PSC.
Can PSC lead to cancer?
Yes. PSC increases the risk of cholangiocarcinoma (bile duct cancer) and gallbladder cancer. Regular monitoring and imaging are important for early detection.
Do diet changes really help?
Yes. A balanced, low-fat diet, adequate hydration, and vitamin supplementation (A, D, E, K) can ease symptoms, support liver health, and improve overall well-being.
