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Sounds like has pretty severe PSC. Ascites is technically only

found in the abdomen. Swelling of the feet is another symptom of low

serum albumin and usually seen before ascites which is fluid in the

abdomen. Scarring or narrowing of the bile ducts is the definition of

PSC and doesn't mean that cholangiocarcinoma is present or not.

Certainly, as stated a number of times at our recent conference, CC is

a concern whose risk increases as time with PSC goes on. It sounds like

has portal hypertension which can be treated a number of ways.

With medication such as beta-blockers or with surgery. We learned that

shunting, the surgery done for portal hypertension, doesn't slow the

progression of PSC or reduce the risk of variceal bleeding. So it may

not be a good option. More frequent upper endoscopies to view and treat

any varices seen might be another good option. Obviously, any lifting

of heavy objects should be avoided. Noting that he works as a mason, it

sounds like going on disability of finding another line of work that

doesn't involve any lifting would be best.

, I live in Ottawa. House is a program on Global or Fox TV. Ticks

that carry Lyme disease are the big issue we've been talking about. I'm

not sure that this disease has made it's way across the continent to

your neck of the woods. It started in the area around Lyme,

Massachusetts.

Aubrey, MD

PSC '81, UC '90, LTX '98, Recurrence '05

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