ERCP Report

[Guest guest]

Thanks so much to all of you who gave me encouragement and advice for

my first ERCP last week. Thanks to the advice you all gave me, I told

my doctors and everyone at the hospital about my anxiety & they gave

me enough sedation that I slept through the whole thing, plus some

combination of two anti-nausea medications that worked like a charm.

I don't even remember being wheeled into or out of the procedure room.

I woke up amazingly clear headed after it was over & only had a sore

throat & a little fatigue for the rest of the day.

The ERCP showed no strictures or blockages, but clear evidence of PSC

or PBC in my bile ducts. According to the layperson explanation the

doc gave my husband, " If the biliary system is like a tree, the trunk

of the tree is fine, the branches are getting thin, and all the leaves

are gone. " The extra-hepatic ducts were all fine. To me this means

all the damage is in my small bile ducts, which suggests PBC more than

PSC. I am now waiting for the Dr to consult with a specialist at Duke

& then I'll have a follow-up visit where he can hopefully explain the

results to me with more clarity.

The doctor also said that PBC is more responsive to Actigall & he

wouldn't expect Actigall to lower my liver enzymes the way it has (in

6 months) if it was PSC. Is that right? Doesn't Actigall lower your

liver enzymes is you have PSC?

Thanks!

Debbie in NC

[Guest guest]

Debbie: my daughter's PSC disease is manifested in the small bile ducts as well; she was definitively diagnosed with PSC as a result of the liver biopsy and ERCP. She takes Asacol and Actigall 6 years out from her diagnosis and has only in the past year started to suffer from severe itching; she takes Rifampine on and off to alleviate the itching. Our doctor said that the small bile duct fibrosis is harder to treat than the large because stenting cannot be done in the small bile ducts. Beth-----Original Message-----From: [mailto: ]On Behalf Of Debbie RasaSent: Wednesday, October 10, 2007 9:29 AMTo: Subject: ERCP ReportThanks so much to all of you who gave me encouragement and advice formy first ERCP last week. Thanks to the advice you all gave me, I toldmy doctors and everyone at the hospital about my anxiety & they gaveme enough sedation that I slept through the whole thing, plus somecombination of two anti-nausea medications that worked like a charm. I don't even remember being wheeled into or out of the procedure room.I woke up amazingly clear headed after it was over & only had a sorethroat & a little fatigue for the rest of the day.The ERCP showed no strictures or blockages, but clear evidence of PSCor PBC in my bile ducts. According to the layperson explanation thedoc gave my husband, "If the biliary system is like a tree, the trunkof the tree is fine, the branches are getting thin, and all the leavesare gone." The extra-hepatic ducts were all fine. To me this meansall the damage is in my small bile ducts, which suggests PBC more thanPSC. I am now waiting for the Dr to consult with a specialist at Duke & then I'll have a follow-up visit where he can hopefully explain theresults to me with more clarity.The doctor also said that PBC is more responsive to Actigall & hewouldn't expect Actigall to lower my liver enzymes the way it has (in6 months) if it was PSC. Is that right? Doesn't Actigall lower yourliver enzymes is you have PSC?Thanks!Debbie in NC The contents of this electronic mail message and any attachments are confidential, possibly privileged and intended for the addressee(s) only. Only the addressee(s) may read, disseminate, retain or otherwise use this message. If received in error, please immediately inform the sender and then delete this message without disclosing its contents to anyone.

[Guest guest]

Hi Debbie;

Actigall does lower serum liver enzymes in PSC. My son's liver enzymes

(especially AST and ALT) normalized within a few weeks after taking

ursodiol (actigall). It took longer for his ALP to come down.

Have you had a blood test for anti-mitochondrial antibodies? Almost all

(95%) of patients with PBC have anti-mitochondrial antibodies, and so

this can easily distinguish between PSC and PBC.

Best regards,

Dave

(father of (23); PSC 07/03; UC 08/03)