Sclerosing cholangitis – How to treat the cause

I saw an interesting gentleman in my clinic recently who had sclerosing cholangitis and wanted to treat it with nutritional medicine. This is a chronic inflammation in the bile ducts which over the years can lead to scarring and narrowing of the bile ducts.

The word sclerosing means scarring and the scar tissue can narrow and distort the structure of the large and small bile ducts. The liver cells surrounding the bile ducts also become inflamed and this is why the liver enzymes are elevated in a liver function blood test.

In some cases, including this man’s case, there is also infection with disease-causing (pathogenic) bacteria in the bile ducts. When the infection flares up, this produces pain over the liver in the right upper abdomen, fever, sweating and muscle aches and pains. To control the infection this man had been prescribed daily antibiotic drugs. He was also prescribed Ursofalk, which is a synthetic form of bile acids.

He felt generally well but wanted to treat the cause of his disease on a deeper level and that is why he came to consult me. The left lobe of his liver had been so badly damaged by this disease that he had it surgically removed and this procedure is called a left hepatectomy. He was worried that the disease would gradually destroy the right lobe of his liver and was trying to avoid a liver transplant. His diet was reasonable and he was Italian and grew his own vegetables in his garden and consumed a lot of olive oil, which is a good fat for the liver. He was physically active and did not drink excess alcohol.

I explained to him that the cause of the inflammation in his bile ducts was caused by two factors –

1. Bacteria growing in the ducts
2. Autoimmune dysfunction where his immune system was attacking the bile ducts

We had to address both these factors if we were to reduce the inflammation that could continue to destroy his bile ducts and the liver cells surrounding the bile ducts.

To achieve these goals I prescribed the following strategy –

• A gluten free diet as his blood test for the HLADQ genotype has shown that he carried the genes for gluten intolerance.
• A good liver tonic containing Milk Thistle, all the B group vitamins, N-Acetyl-Cysteine (NAC), selenium, antioxidants and sulphur containing amino acids. I asked him to take 2 capsules twice daily of Livatone Plus. This would increase the production of glutathione in his liver.
• Vitamin C to reduce scarring in the bile ducts.
• An increased intake of water and raw juices to promote the flow of healthy bile. Suitable things to include in the juice are ginger, citrus, kale, cabbage, carrot, parsley and green apple. For more juice ideas, read my Raw Juices Can Save Your Life book. I also recommended broccoli sprouts powder to increase sulphoraphane which supports detoxification.
• An increased dietary intake of foods high in sulphur such as garlic, onions, chives and radishes, as well as an MSM supplement because it is rich in natural sulphur.
• An increased intake of essential fatty acids from oily fish, avocado, flax seeds, hemp seeds, chia seeds and fresh walnuts.
• Natural antibiotics to reduce the population of unhealthy bacteria in his intestines. This would reduce the source of the infection in his bile ducts, which was coming from the unhealthy bacteria in his intestines. I gave him Bactoclear capsules, which contain antibiotic herbs in an enteric coated capsule.
• Fermented foods such as Greek yogurt, coconut yogurt, kefir, kombucha and sauerkraut.
• Apple cider vinegar with his meals – sip two tablespoons of organic apple cider vinegar in a small glass of warm water during meals.

Other foods and herbs that can exert anti-inflammatory and protective effects in the liver include-

• Sesame seeds (best consumed as tahini paste or hummus) contain sesamin, which has liver protective effects
• Cruciferous vegetables – such as broccoli, cabbage, Brussels sprouts, cauliflower, kale and watercress; these contain powerful protective liver factors such as sulforaphane and Indol-3-carbinol.
• Turmeric, which contains curcumin and induces phase 2 glutathione conjugation, increases glutathione production and is anti-inflammatory
• Citrus fruits and caraway seeds contain D-Limonene, which enhances elimination of carcinogenic metabolites from the liver

I have had many patients with autoimmune diseases of the liver, ranging from autoimmune hepatitis, primary biliary cirrhosis (PBC) and sclerosing cholangitis, who have been able to get their liver function back to normal and arrest the inflammation in their liver. This takes a little bit of effort and a change in diet for many sufferers but the outcome achieved is well worth the effort.

Nutritional medicine is evidence based and very scientific and needs to be used much more widely in liver clinics.

The above statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any disease.