Question: What are the symptoms of PSC?
Answer: Symptoms of primary sclerosing cholangitis (PSC) may include

pain in theabdomen, or belly
itchy skin
diarrhea
yellowish color of the whites of the eyes and skin, calledjaundice
feeling tired or weak
fever

PSC may lead to a bile duct infection. Symptoms of a bile duct infection include

chills
fever
new or worsening jaundice
pain in the upper right side of the abdomen

As the disease gets worse, you may develop cirrhosis. Symptoms of cirrhosis may include

swelling of the abdomen from a buildup of fluid, calledascites
confusion or difficulty thinking caused by a buildup of toxins in the brain, calledhepatic encephalopathy
gastrointestinal bleedingcaused when enlargedveins—called varices—burst in theesophagus,stomach, orintestines
othersymptoms of cirrhosis, such asedema, jaundice, and weight loss

Because PSC gets worse slowly, you can have the disease for years before you have any symptoms. Many people have no symptoms when they are first diagnosed with PSC.
Question: What causes PSC?
Answer: Experts aren’t sure what causes PSC. Studies suggest that several factors may play a role, including

genes
immune systemproblems
changes in thebacteriain thedigestive tract, also called gut flora or the gut microbiome
bile ductinjury caused bybile acids