Medicines to treat primary sclerosing cholangitis have not been found effective yet. Studies indicate that a drug ursodeoxycholic acid or ursodiol may be useful, but further studies are needed to establish this.
The symptoms, however, may respond to drugs. Itching is treated with drugs like cholestyramine, sertraline, naloxone or rifampicin. Bone disease may respond to calcium and vitamin D supplementation. Infection of the bile ducts needs antibiotics.
Strictures in the bile ducts may be dilated during endoscopic retrograde cholangiography procedure. A tube with a deflated balloon is introduced into the liver through the endoscope until it reaches the narrow part of the bile duct. In this position, the balloon is inflated, thus resulting in widening of the narrowed part. Stents or small tubes may be placed in the bile ducts to relieve the obstruction. However, the stents could result in increased chances of infection.
Liver transplantation helps to improve survival in patients with primary sclerosing cholangitis. Some people however may develop sclerosing cholangitis in the transplanted liver.
Complications like gall bladder stones and polyps may necessitate removal of the gall bladder.