Hello and welcome to the Zero to Finals podcast.

My name is Tom and in this episode I'm going to be talking to you about primary sclerosing colangitis.

If you want to follow along with written notes on this topic, you can follow along at

0.com slash primary sclerosing colangitis or in the gastroenterology section of the zero

de finals medicine book. Let's get straight into it. Primary sclerosing colangitis is a condition where

the intra-herpatic and the extra-hypatic ducts become strictured and fibrotic. So if we look at the name, sclerosis means

stiffening or hardening, and colangitis refers to inflammation of the bile ducts. So this is

stiffening and hardening of the bile ducts and inflammation of the bile ducts. And remember that the

bile ducts are responsible for taking the bile ducts are responsible for

taking the bile that's produced in the liver down that small tube that we call the duct and into the

intestines. When we talk about strictures, we mean narrowing and when we talk about fibrosis, we mean

hardening. So this narrowing and hardening of the bile ducts causes an obstruction to the flow of bile

out of the liver and into the intestines.

Now chronic obstruction of bile eventually leads to a back pressure of bile into the liver,

causing liver inflammation, which we call hepatitis,

which leads onto fibrosis of the liver tissue, and then ultimately liver cirrhosis. The cause is mostly unclear, although there's

probably a combination of genetic, autoimmune, intestinal microbiome and environmental factors,

and we know there's a well-established link between

ulcerative colitis and primaries chlorosin colangitis. And this is quite a common question in the exams.

So if you spot a patient who has ulcerative colitis in your exams, and they start to have liver

symptoms and signs, Think about primaries

chloros in colangitis. In fact, about 70% of cases of primaries clois and colangitis are associated

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