Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Primary sclerosing cholangitis (PSC) is a chronic (lasting years and
decades), progressive (worsening over time) disease of the bile ducts that
channel bile from the liver into the intestines.
The liver performs many functions; one of them is manufacturing bile. Bile is
a watery liquid made by the cells of the liver that is important for digesting
food in the intestine, particularly fat, and ridding the body of toxins. Liver
cells secrete the bile they make into small canals within the liver. The bile
flows through the canals and into larger collecting canals (ducts) within the
liver (the intrahepatic bile ducts). The bile then flows within the intrahepatic
bile ducts out of the liver and into the extrahepatic bile ducts. From the
extrahepatic bile ducts, the bile flows into the intestine where the bile mixes
with food.
In primary sclerosing cholangitis, the intrahepatic and extrahepatic bile ducts become inflamed, scarred
and thickened (sclerotic), narrowed, and finally obstructed. Obstruction of the
ducts can lead to abdominal pain,
itching, jaundice, infection in the bile ducts
(cholangitis), and liver scarring that leads to
liver cirrhosis and liver
failure.
How common is primary sclerosing cholangitis?
Primary sclerosing cholangitis is a rare disease with an estimated prevalence in the United States of 6
per 100,000 people. It is more common in men then in women; approximately 70% of
primary sclerosing cholangitis patients are men. The mean age at diagnosis of
primary sclerosing cholangitis is around 40 years of
age.
There is a strong association between primary sclerosing cholangitis and chronic ulcerative colitis.
Primary sclerosing cholangitis
can also occur alone or in association with Crohn's disease, a disease of the
intestines that is related to ulcerative colitis.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Crohn's disease is a chronic inflammatory disease,
primarily involving the small and large intestine, but which can
affect other parts of the digestive system as well. Abdominal pain, diarrhea, vomiting, fever, and weight loss are
common symptoms.
Liver cancer is the fifth most common cancer in the world and the majority of patients with liver cancer will die within one year as a result. Patients with associated cirrhosis caused by chronic hepatitis B or C infections, alcohol, and hemochromatosis are at the greatest risk of developing liver cancer. Many patients with liver cancer do not develop symptoms until the advanced stages of the tumor which usually makes prognosis poor. The combination of an imaging study (ultrasound, CT, or MRI scans) and an elevated blood level of alpha-fetoprotein will most effectively diagnose liver cancer, while a liver biopsy can make a definitive diagnosis. Medical treatments, including chemotherapy, chemoembolization, ablation, and proton beam therapy, are not very effective. Surgical removal of the tumor or a liver transplant may be most effective in certain cases.
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections. Symptoms include yellowing of the skin, itching, and fatigue.
Colon cancer is a malignancy that arises from the inner lining of the colon. Most, if not all, of these cancers develop from colonic polyps. Removal of these precancerous polyps can prevent colon cancer.
Itching can be a common problem. Itches can be localized or generalized. There are many causes of itching to include: infection (jock itch, vaginal itch), disease (hyperthyroidism, liver or kidney), reactions to drugs, and skin infestations (pubic or body lice). Treatment for itching varies depending on the cause of the itch.
Jaundice is a yellowish staining of the skin and whites of the eyes (sclerae) with bilirubin, the pigment found in bile. Jaundice can be an indicator of liver or gallbladder disease, or it may result from the rupture of red blood cells (hemolysis).
Ulcerative colitis is a chronic inflammation of the colon. Symptoms include abdominal pain, diarrhea, and rectal bleeding. Ulcerative colitis is closely related to Crohn's disease, and together they are referred to as inflammatory bowel disease. Treatment depends upon the type of ulcerative colitis diagnosed.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
Ulcerative colitis is a chronic inflammation of the large intestine (colon). The colon is the part of
the digestive system where waste material is stored. The rectum is the end of
the colon adjacent to the anus. In patients with ulcerative colitis, ulcers and
inflammation of the inner lining of the colon lead to symptoms of
abdominal
pain, diarrhea, and
rectal
bleeding.
Ulcerative colitis is closely
related to another condition of inflammation of the intestines called Crohn's
disease. Together, they are frequently referred to
as inflammatory bowel disease (IBD).
Ulcerative
colitis and Crohn's diseases are chronic conditions that can last
years to decades. They affect approximately 500,000 to 2 million people In the
United States. Men and women are affected equally. They most commonly begin
during adolescence and early adulthood, but they also can begin during childhood
and later in life.
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