Curbside Consultation of the Liver: 49 Clinical Questions

Mitchell L. Shiffman, MD

Question 36: My Patient With Ulcerative Colitis Recently Underwent A Total Colectomy For Severe Dysplasia. Does This Reduce The Risk That He Will Get Primary Sclerosing Cholangitis? (continued)

Michael Fuchs, MD, PhD, FEBG

Forty-two years ago, the association between primary sclerosing cholangitis (PSC) and ulcerative colitis (UC) was described and confirmed by investigators around the world. UC can be diagnosed at any time during the course of PSC, and vice versa. In general, UC is diagnosed several years earlier than PSC and PSC may even develop following colectomy for UC.1 Epidemiological studies demonstrated that the prevalence of UC in patients with PSC varies from 21% to 80%.2 This strongly supports screening colonos-copy for patients with PSC. The prevalence of PSC in patients with UC, however, is much…