At present there is no known cure or specific treatment for PSC although preliminary trials have suggested that the natural bile acid, ursodeoxycholic acid, may slow the progression of the disease possibly by increasing bile flow and reducing liver inflammation. Symptoms such as itching can be treated with agents such as cholestyramine, rifampicin or naltrexone.
Cholestyramine (trade name Questran® or Questran Light®) may be prescribed to help relieve itching. It works better when taken before and after meals, especially breakfast, but it may take some days before the treatment is effective. Some people taking Questran® experience side effects such as altered bowel habits or bloating. If this is a problem, tell your doctor as there are other treatments such as albumin dialysis that may suit you better.
Many people suffer with a dry mouth and dry eyes, but this can be helped by taking lozenges and artificial tears prescribed by your doctor.
For a few people who eventually go on to get advanced cirrhosis, a liver transplant may be recommended when their quality of life has deteriorated and medical treatment can no longer control their symptoms. Because PSC usually develops slowly, transplantation can generally be carefully planned well ahead.
People with advanced PSC are often deficient in vitamins A, D and K and replacement fat-soluble vitamins are given. Endoscopic treatment of the bile ducts is aimed at reducing or halting the progression of the disease, usually by stretching or dilating the narrowed bile ducts. In later stages of the disease liver transplantation is often an option. Survival after this operation is good, although in some patients PSC can recur in the new liver.