The course of the disease is unpredictable for the patient, but is generally slowly progressive. The patient may have the disease formany years before symptoms develop. Symptoms may persist at a stable level, be intermittent, or progress gradually. Liver failure may occur after 7-15 years of disease or even longer. There is currently no specific treatment for primary sclerosing cholangitis.
Research is under way to determine the effectiveness of a number of medications.
The various symptoms of primary sclerosing cholangitis often respond effectively to medications that control itching, antibiotics when recurrent infections occur, and vitamins to replace those that are deficient. In some instances, endoscopic, radiologic, or surgical techniques may be employed to open major blockages in the common bile duct and improve bile flow. When progressive liver failure occurs in spite of these measures, liver transplantation may be indicated.