Primary Sclerosing Cholangitis and Ulcerative Colitis: What to Know

“The treatment of ulcerative colitis is not affected by the presence of primary sclerosing cholangitis,” says James Cox, MD, a gastroenterologist, an assistant professor, and the director of clinical skills development and physician communication at Burnett School of Medicine at Texas Christian University in Fort Worth. But PSC treatments can be offered alongside UC treatment.

Also, UC treatments don’t reliably treat the liver, says Awoniyi. Standard UC immunosuppressants and biologics can spark healing in the intestinal lining, but rarely change PSC progression, he adds. But researchers are testing alternative approaches. “Several small studies of oral antibiotics — most notably vancomycin — show meaningful reductions in colitis activity (clinical and endoscopic) in PSC‑UC,” says Awoniyi.