Symptoms & Causes of Primary Sclerosing Cholangitis
What are the symptoms of PSC?
The main symptoms of primary sclerosing cholangitis (PSC) are
- feeling tired or weak
- itchy skin
Other symptoms may include
- losing weight without trying
- poor appetite
- fever
- pain in the abdomen
As the disease gets worse, you may get symptoms of cirrhosis and liver failure, such as
- bloating
- bruising and bleeding easily
- confusion, difficulty thinking, or memory loss
- redness in the palms of your hands
- swelling in your legs, ankles, or feet
- yellowish eyes and skin, called jaundice
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.

What causes PSC?
The cause of PSC is not known. However, one or more of the following may play a role in causing the disease:
- genes
- immune system problems
- changes in the bacteria in your gastrointestinal tract, also called gut flora or gut microbiome
- bile duct injury caused by bile acids
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Keith D. Lindor, M.D., Arizona State University