When someone has a long-term liver problem such as PSC, the liver’s ability to carry out its many functions may not be as good as in a healthy person.
Diet
In particular, the liver’s ability to break down alcohol and medicines may be impaired, however this is often not a problem. If in doubt, check with your doctor.
Many people with PSC can eat a normal diet, while others may need more detailed advice. If you are well with few symptoms you may not need to make any changes, although it is important to eat as healthily as possible.
If you have cirrhosis or other complications such as fluid retention (ascites and oedema) or mental slowness or confusion (encephalopathy), you may need specialist advice from a State
Registered Dietician.
A few people have problems digesting fat and can develop a type of diarrhoea called steatorrhoea, in which stools are bulky, pale and difficult to flush away. There may also be nausea. If this occurs, it may help to reduce the amount of fat in the diet under the supervision of a dietician. A low fat diet should be followed only if steatorrhoea is causing problems.
The aim of a low fat diet is to improve the diarrhoea, abdominal pain and discomfort associated with steatorrhoea. As fat is an important source of energy, anyone following a low fat diet should eat extra carbohydrate, such as starch and sugar.
Some people may need energy supplements and injections of fat-soluble vitamins. Others are prescribed medium chain triglycerides (MCT) which are fats that are easier to digest.
A few people experience heartburn and an unpleasant taste in the mouth, usually caused by acid from the stomach going back up into the gullet. Eating small amounts often helps. A good idea is always to carry something to eat, preferably food which contains carbohydrate.
It is important to talk to your doctor or dietician before making any changes in your diet.
Alcohol
Many people with PSC find that they can no longer tolerate alcohol. Some may be advised to drink only a little on special occasions while others should not drink at all.
Sensible drinking advice varies from person to person and will depend on many factors, such as the severity and stage of the disease, as well as your general health. Your specialist is the best person to advise.
Tiredness is the commonest symptom of PSC. Some people may need to consider making
changes to their lifestyle, such as giving up work or a particular activity. Some people find that pacing their daily activities helps to preserve stamina and energy. Gentle exercise such as walking and swimming can be beneficial.
It is important to tell your dentist that you have PSC as there may be an increased risk of bleeding.
Also, there are a few medicines that are best avoided, and the dose of others may need to be reduced. For example, it is better to take paracetamol rather than aspirin to combat aches and pains. However, you should check this with your doctor first; they are best equipped to advise you.
Important
Talk to your doctor before taking any medicine (not prescribed by him or her), including paracetamol, herbal remedies and Chinese medicine.
If you are female and middle aged, it is important to discuss with your doctor the best way of reducing your risk of developing osteoporosis.
Your doctor may advise various measures which might include increasing the intake of calcium in your diet, taking calcium supplements and HRT (hormone replacement therapy) if appropriate.
Most doctors will also advise not smoking.
If you are concerned by any of the symptoms mentioned in the leaflet, it is important that you consult your doctor.