Primary sclerosing cholangitis secondary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]
Overview
Secondary prevention in patients with primary sclerosing cholangitis is aimed at screening for complications and coexisting conditions in these patients. These include screening for complications of liver cirrhosis, screening for colon and gallbladder cancers, as well as metabolic bone disease.
Secondary Prevention
Secondary prevention in patients with primary sclerosing cholangitis is aimed at screening for complications and coexisting conditions in these patients. These include:[1][2][3]
Complications/ Coexisting Conditions | Presentation | Screening | Management |
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Liver Cirrhosis |
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Gallbladder disease | Polyps/ masses | Abdominal ultrasound | Consider prophylactic cholecystectomy in patients with gallbladder polyps and masses, due to high risk of carcinoma. Chemotherapy is added if there is evidence of gallbladder cancer extending beyond the wall of the gallbladder. |
IBD and associated risk of colon cancer | Colon cancer | Colonoscopy annually | In case of colon cancer, treat with colectomy. Chemotherapy is added to treatment regimen according to guidelines of the treatment of colon cancer. |
Metabolic bone disease | Osteopenia/ osteoporosis | DEXA scan. Repeat every 2-3 years. | For osteopenia and osteoporosis, treat with calcium 1.0-1.5 g/day and vitamin D of 1,000 IU/day. Add bisphosphonates in the case of osteoporosis. |
References
- ↑ Lazaridis KN, LaRusso NF (2016). "Primary Sclerosing Cholangitis". N. Engl. J. Med. 375 (12): 1161–70. doi:10.1056/NEJMra1506330. PMID 27653566.
- ↑ Chapman R, Fevery J, Kalloo A, Nagorney DM, Boberg KM, Shneider B, Gores GJ (2010). "Diagnosis and management of primary sclerosing cholangitis". Hepatology. 51 (2): 660–78. doi:10.1002/hep.23294. PMID 20101749.
- ↑ Kumar A, Wheatley D, Puttanna A (2016). "Primary Sclerosing Cholangitis: Therapeutic Options and Surveillance Management". Clin Med Insights Gastroenterol. 9: 25–9. doi:10.4137/CGast.S38451. PMC 4902039. PMID 27330336.