By: Ford Prefect
Primary Sclerosing Cholangitis (PSC) is a progressive liver disease that can silently cause serious harm before symptoms even appear. At the center of this condition are the bile ducts. These small channels drain bile from the liver into the intestines, helping digest food and remove toxins. But with PSC, they can become inflamed, scarred, and eventually blocked.
When Bile Stops Moving, Damage Can Begin
PSC doesn’t simply inflame the bile ducts—it causes damage to them. As they become increasingly scarred, bile flow can slow down or stop altogether. This backed-up bile, containing digestive enzymes and waste products, may seep into the liver.
Then you’re faced with two significant problems: It becomes harder to digest food properly, and all the toxins your liver was processing can’t get out.
Without a functioning bile duct, the liver can’t perform properly. Over time, this toxic buildup can cause permanent liver damage. If left untreated, liver cirrhosis or even organ failure could occur. Most likely, by then, the only option would be a liver transplant.
A Silent Threat with Repeated Infections
An often overlooked threat of PSC is frequent infection. When the bile ducts are damaged, they can become a breeding ground for bacteria, leading to recurrent cholangitis. You may also develop chronic cholangitis that doesn’t resolve, which further impacts your overall health.
It’s not uncommon for a patient to need hospitalization multiple times per year to treat serious infections or to manage symptoms like fever, abdominal pain, or jaundice that may result from bacterial overgrowth in the stagnant bile.
Why Early Diagnosis Makes a Difference
The most compelling reason to raise awareness about PSC is that if the disease is detected early, it’s possible to preserve the bile ducts. With early detection, patients may avoid some of the complications that arise later. Monitoring and treatment from the beginning can help stop infections, slow liver disease progression, and improve quality of life.
Early diagnosis might also allow patients to participate in clinical trials of new treatments. Although no cure is currently available, research is advancing, and more treatment options are emerging for those diagnosed sooner.
A Closer Look at Ongoing Research
Dr. Bertus Eksteen, a physician-scientist based in Calgary, is leading efforts to understand and treat PSC. Throughout his career, Dr. Eksteen’s primary research focus has been autoimmune liver diseases, particularly PSC. He oversees one of the largest PSC clinical trial centers globally at Aspen Woods Clinic and has contributed to several significant advances.
He was among the first to discover that gut immune cells can inadvertently target the liver in PSC patients. He’s also been involved in identifying genetic markers that can increase the likelihood of someone developing the disease. These findings are not merely academic—they’re helping shape how doctors approach diagnosis and treatment.
At the same time, Dr. Eksteen and his team have worked on pioneering imaging tools to identify early changes in the bile ducts. These tools are already helping doctors detect pre-cancerous cells in PSC patients.
What Patients Should Watch For
PSC can often go undetected. Many people don’t realize they have the disease until it’s in its later stages. This is why early signs of PSC should never be ignored. Some symptoms may include feeling fatigued, itchy skin, jaundice, dark urine, or unexplained weight loss. Although these symptoms may initially seem mild or common, they could be indicators of serious liver issues.
Anyone with inflammatory bowel disease (IBD), particularly ulcerative colitis, is at higher risk for PSC. A family history of autoimmune diseases could also increase your risk.
Tests may include liver function panels and imaging like MRCP (magnetic resonance cholangiopancreatography) or a liver biopsy. These tests are non-invasive enough that the benefits of early diagnosis generally outweigh any risks.
Protecting the Liver Before It’s Too Late
By the time a liver becomes heavily scarred, there’s little that can be done except for a transplant. That’s why slowing PSC in its early stages is so critical. With careful monitoring, patients can take steps to manage symptoms and reduce complications. Doctors might prescribe medications to reduce inflammation or perform procedures to open up narrowed bile ducts.
PSC patients should also aim to live a healthy lifestyle. While diet cannot cure the disease, it’s important to avoid alcohol, stay active, and maintain an ideal body weight. Regular monitoring helps ensure that infections and other complications are addressed before they worsen.
Where Science Meets Advocacy
Dr. Eksteen’s influence extends beyond the lab. As a representative for the Alberta Medical Association and a member of the Joint Physician Advocacy Committee, he is advocating for improvements in patient care. His push for stronger collaboration between specialists and family doctors is helping shape a better care model for patients with diseases like PSC.
Dr. Eksteen believes in putting patients at the center—a message that resonates in his medical research and policy work. His efforts are contributing to changes in how we treat PSC and deliver care.
The Bottom Line: Timing Is Everything
PSC doesn’t progress quickly at first, but once it does, it can be relentless. That’s why timing matters. The longer you go undiagnosed, the more damage it could do to your liver, your quality of life, and your long-term health.
Thanks to experts like Dr. Eksteen and the continued work of dedicated researchers, we understand more about PSC than ever before. Now, we need to focus on early detection—it could be the difference between living with the disease and struggling with its more severe consequences.
Disclaimer: The information presented in this article is for general informational purposes only and is not intended as medical advice. While the article discusses Primary Sclerosing Cholangitis (PSC) and its effects on the liver based on insights from Dr. Bertus Eksteen, it is important to consult a healthcare professional for any diagnosis, treatment, or medical advice. The research and opinions mentioned reflect current understanding and ongoing studies, but they do not guarantee any specific outcomes. Always seek professional medical guidance before making decisions about your health or treatment options.
Published by Jeremy S.
