Therapy is directed towards treating symptoms, preventing and managing complications of PSC. Patients with PSC should avoid anything that may cause or worsen liver damage such as alcohol. Vaccinations for hepatitis A and B should be administered. Vitamin supplements should be prescribed for patients with advanced disease at risk for deficiencies. Medications such as diphenhydramine, cholestyramine, rifampin and phenobarbital have been helpful in relieving itching. Osteoporosis is managed with supplemental calcium and vitamin D. Treatment of itching and osteoporosis in PSC is similar to that used for treating Primary Biliary Cirrhosis (see below). Alendronate is a medication often used to decrease further bone loss that may help in PSC.
6. Nicotine from smoking is one of the worst things patients can do after weight loss surgery, due to the high risk of ulceration of the stomach. Don’t smoke! I know a brilliant and charming businessman who 8 months after gastric bypass nearly died when nicotine ate a hole in his pouch and his stomach contents emptied into his abdominal cavity. He woke up in ICU and learned he had been there for six weeks, three of them as a John Doe as he was walking without ID when his medical issue occurred. He had quit smoking for his surgery, but started back. It took two surgeries and six months for him to recover.