Podcasts

PBC vs. PSC – Spotting the Differences

In this expert-led podcast, "PBC vs. PSC: Spotting the Differences," Dr. Chris Bowlus and Dr. Kris Kowdley break down the essential clinical distinctions between primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC), using real-world cases and evidence-based insights. From initial symptoms like fatigue and pruritus to interpreting cholestatic liver enzyme patterns, they walk through the optimal diagnostic workup, including AMA testing, MRCP imaging, liver biopsy, and the evolving role of genetic testing and elastography.

The discussion explores challenges in differentiating PBC from conditions like MASLD, how to use AMA titers and PBC-specific antibody panels for accurate diagnosis, and key imaging findings. They also cover best practices in surveillance for cholangiocarcinoma in PSC, the role of colonoscopy for IBD screening, and modern management strategies including UDCA, IBAT inhibitors, and newly approved second-line therapies like seladelpar and elafibranor for PBC. This episode is a must-listen for hepatologists, GI specialists, and clinicians managing patients with autoimmune and cholestatic liver diseases.