Since people with primary sclerosing cholangitis may not have noticeable symptoms for many years, the disease often is suspected due to abnormal blood tests (taken for other reasons) that show a high level of liver enzymes (which indicate abnormal liver function). The disease also might be suspected due to a history of inflammatory bowel disease.
X-ray techniques can reveal whether bile ducts are blocked; however, they may not be able to determine the cause or site of the possible obstruction.
Sclerosing cholangitis is diagnosed by injecting dye into the bile ducts and taking an X-ray. The test can determine the cause and site of the blockage.
After the child is sedated (given medication that has a soothing and calming effect), a lighted and flexible endoscope (instrument used to visually examine the inside of certain body parts) is inserted through the mouth, stomach and then into the small intestine.
A thin tube is placed through the scope and into the pancreatic and bile ducts, and the dye is injected to show the bile ducts on the X-ray. If the X-ray shows the bile ducts are narrowed, the doctor diagnoses the problem as primary sclerosing cholangitis.
As the disease progresses, a liver biopsy usually is needed to determine how much liver damage has occurred.