Editing Primary sclerosing cholangitis (section)

==Signs and symptoms==
Nearly half of people with PSC do not have symptoms, and are often incidentally discovered to have PSC due to abnormal [[liver function tests]];<ref name="Lazaridis2016"/> however, a substantial proportion have debilitating signs and symptoms of the disease.<ref name="ReferenceA">{{cite journal | vauthors = Tabibian JH, Lindor KD | title = Ursodeoxycholic acid in primary sclerosing cholangitis: if withdrawal is bad, then administration is good (right?) | journal = Hepatology | volume = 60 | issue = 3 | pages = 785–788 | date = September 2014 | pmid = 24752961 | doi = 10.1002/hep.27180 | s2cid = 5341568 | doi-access = free }}</ref> Signs and symptoms of PSC may include severe [[pruritus|itching]] and nonspecific fatigue. [[Jaundice]] may also be seen. Enlargement of the [[hepatomegaly|liver]] and [[splenomegaly|spleen]] are seen in roughly 40% of affected individuals. Abdominal pain affects about 20% of people with PSC.{{cn|date=March 2022}}

Multiple episodes of life-threatening acute [[cholangitis]] (infection within the bile ducts) can be seen due to impaired drainage of the bile ducts, which increases the risk of infection.<ref>{{cite journal | vauthors = Tabibian JH, Yang JD, Baron TH, Kane SV, Enders FB, Gostout CJ | title = Weekend Admission for Acute Cholangitis Does Not Adversely Impact Clinical or Endoscopic Outcomes | journal = Digestive Diseases and Sciences | volume = 61 | issue = 1 | pages = 53–61 | date = January 2016 | pmid = 26391268 | doi = 10.1007/s10620-015-3853-z | s2cid = 8266015 }} Epub 2015 Sep 21.</ref>
* Dark urine due to excess [[conjugated bilirubin]], which is water-soluble and excreted by the kidneys (i.e. choluria)
* [[Malabsorption]], especially of [[fat]], and [[steatorrhea]] (fatty stool), due to an inadequate amount of bile reaching the small intestine, leading to decreased levels of the fat-soluble [[vitamin]]s, [[vitamin A|A]], [[vitamin D|D]], [[vitamin E|E]], and [[vitamin K|K]].
* [[Portal hypertension]], a complication of [[cirrhosis]], which can manifest with [[Esophageal varices|esophageal]] and parastomal varices<ref>{{cite journal | vauthors = Tabibian JH, Abu Dayyeh BK, Gores GJ, Levy MJ | title = A novel, minimally invasive technique for management of peristomal varices | journal = Hepatology | volume = 63 | issue = 4 | pages = 1398–1400 | date = April 2016 | pmid = 26044445 | doi = 10.1002/hep.27925 | s2cid = 34965702 | doi-access = free }}</ref> as well as [[hepatic encephalopathy]] (mental status alteration/disturbance caused by liver dysfunction and shunting of blood away from the scarred liver; such that ammonia detoxification is reduced with concomitant encephalopathy) or [[ascites]].