Treatment for Primary Sclerosing Cholangitis

How do doctors treat PSC?

Doctors can’t cure primary sclerosing cholangitis (PSC) or keep the disease from getting worse. However, they can treat narrowed or blocked bile ducts and the symptoms and complications of PSC.

Narrowed or blocked bile ducts

If your bile ducts are narrowed or blocked, your doctor may use medical procedures, such as endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography, to open them and help keep them open.

Itchy skin

Your doctor may recommend over-the-counter products and medicines or prescribe medicines to treat itchy skin. Over-the-counter products and medicines include

For mild itchy skin, your doctor may prescribe hydroxyzine. For severe itchy skin, your doctor may prescribe cholestyramine.

Low levels of fat-soluble vitamins in your body

If you have low levels of fat-soluble vitamins in your body, your doctor may recommend dietary supplements of vitamins A, D, E, and K. Follow your doctor’s instructions on the type and amount of vitamins you should take.

Bile duct infection

Your doctor may prescribe an antibiotic to treat a bile duct infection.


If your PSC has caused cirrhosis, your doctor may treat the health problems related to cirrhosis with medicines, surgery, and other medical procedures. If cirrhosis leads to liver failure, you may need a liver transplant.

Prescription bottle on its side with pills.
Your doctor may prescribe antibiotics to treat a bile duct infection.

When do doctors consider a liver transplant for PSC?

Your doctor may consider a liver transplant if your PSC has caused liver failure. Doctors consider liver transplants only after all other treatment options have failed.

What can I do to prevent further liver damage?

To help prevent further liver damage, you can do the following:

  • Carefully follow your doctor’s instructions.
  • Take your medicines and vitamins as directed.
  • If you smoke, quit smoking.
  • Do not drink any alcohol or use illegal drugs.
  • Have regular checkups, as recommended by your doctor.
  • Talk with your doctor before taking
  • Try to keep a healthy body weight.
Last Reviewed January 2018

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