Box 2.

Ways in which a patient with primary sclerosing cholangitis may present to the general physician

Incidental findings of abnormal liver biochemistry in an asymptomatic individual
Persistent abnormal liver biochemistry in patients followed up for inflammatory bowel disease
Jaundice or pruritis secondary to cholestasis
Bacterial cholangitis
Jaundice secondary to liver decompensation
Complications of portal hypertension (variceal bleeding or ascites)
Cholangiocarcinoma or gallbladder carcinoma