Ulcerative colitis and sclerosing cholangitis. History of the MCSC patient.

News 12/05/2023

A 25-year-old man turned to the Department of Inflammatory Bowel Diseases of the MCSC named after A. S. Loginov. In an interview with the doctor, he said that in January 2019, he had paroxysmal pain in the left part of the abdomen and loose stools with blood up to 10 times a day. At the same time, for several years he was treated in a polyclinic for a chronic liver disease with elevated levels of gammaglutamyltranspeptidase and alkaline phosphatase.

How was the diagnosis performed?

After the consultation, the specialists recommended a colonoscopy, as a result of which the patient was found to have ulcers and other signs of inflammation of the sigmoid and rectum, as well as laboratory teststhat confirmed the violation of liver function.

To clarify the degree of liver damage, the patient underwent magnetic resonance cholangiopancreatography. Thickening of the walls and deformation of the intrahepatic bile ducts were found, which directly indicated signs of sclerosing cholangitis.

Diagnosis

The results of these studies allowed to make a diagnosis: ulcerative colitis, left-sided lesion, first detected, moderate severity, high activity and primary sclerosing cholangitis.

Treatment

As a result, treatment with glucocorticosteroids, 5-aminosalicylic acid and ursodeoxycholic acid was prescribed, after which the disease went into remission: diarrhea with blood stopped, laboratory parameters of liver function returned to normal. Our doctors recommended further follow-up in the department.

This story is typical of the systematic approach to bowel diseases in our Center. In this case, the violation of the functional tests of the liver was actually the first sign of a latent inflammation of the colon. Therefore, if there are signs of inflammation of the biliary tract, we recommend examining the intestines with a colonoscopy, even if there are no clinical symptoms of the disease. This is also necessary because the combination of ulcerative colitis and sclerosing cholangitis, as shown by our research, there is a high risk of developing colon cancer. Specialists of the MCSC have extensive experience in diagnosing its early signs in the form of dysplasia of the cells of the intestinal mucosa and use modern treatment methods. Such "pitfalls" that lie in wait for patients with bowel and liver diseases are well known to our doctors.

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