Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Primary sclerosing cholangitis (PSC) is a chronic (lasting years and
decades), progressive (worsening over time) disease of the bile ducts that
channel bile from the liver into the intestines.
The liver performs many functions; one of them is manufacturing bile. Bile is
a watery liquid made by the cells of the liver that is important for digesting
food in the intestine, particularly fat, and ridding the body of toxins. Liver
cells secrete the bile they make into small canals within the liver. The bile
flows through the canals and into larger collecting canals (ducts) within the
liver (the intrahepatic bile ducts). The bile then flows within the intrahepatic
bile ducts out of the liver and into the extrahepatic bile ducts. From the
extrahepatic bile ducts, the bile flows into the intestine where the bile mixes
with food.
In primary sclerosing cholangitis, the intrahepatic and extrahepatic bile ducts become inflamed, scarred
and thickened (sclerotic), narrowed, and finally obstructed. Obstruction of the
ducts can lead to abdominal pain,
itching, jaundice, infection in the bile ducts
(cholangitis), and liver scarring that leads to
liver cirrhosis and liver
failure.
How common is primary sclerosing cholangitis?
Primary sclerosing cholangitis is a rare disease with an estimated prevalence in the United States of 6
per 100,000 people. It is more common in men then in women; approximately 70% of
primary sclerosing cholangitis patients are men. The mean age at diagnosis of
primary sclerosing cholangitis is around 40 years of
age.
There is a strong association between primary sclerosing cholangitis and chronic ulcerative colitis.
Primary sclerosing cholangitis
can also occur alone or in association with Crohn's disease, a disease of the
intestines that is related to ulcerative colitis.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Liver cancer is the fifth most common cancer in the world and the majority of patients with liver cancer will die within one year as a result. Patients with associated cirrhosis caused by chronic hepatitis B or C infections, alcohol, and hemochromatosis are at the greatest risk of developing liver cancer. Many patients with liver cancer do not develop symptoms until the advanced stages of the tumor which usually makes prognosis poor. The combination of an imaging study (ultrasound, CT, or MRI scans) and an elevated blood level of alpha-fetoprotein will most effectively diagnose liver cancer, while a liver biopsy can make a definitive diagnosis. Medical treatments, including chemotherapy, chemoembolization, ablation, and proton beam therapy, are not very effective. Surgical removal of the tumor or a liver transplant may be most effective in certain cases.
Crohn's disease is a chronic inflammatory disease,
primarily involving the small and large intestine, but which can
affect other parts of the digestive system as well. Abdominal pain, diarrhea, vomiting, fever, and weight loss are
common symptoms.
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections. Symptoms include yellowing of the skin, itching, and fatigue.
Colon cancer is a malignancy that arises from the inner lining of the colon. Most, if not all, of these cancers develop from colonic polyps. Removal of these precancerous polyps can prevent colon cancer.
Jaundice is a yellowish staining of the skin and whites of the eyes (sclerae) with bilirubin, the pigment found in bile. Jaundice can be an indicator of liver or gallbladder disease, or it may result from the rupture of red blood cells (hemolysis).
Ulcerative colitis is a chronic inflammation of the colon. Symptoms include abdominal pain, diarrhea, and rectal bleeding. Ulcerative colitis is closely related to Crohn's disease, and together they are referred to as inflammatory bowel disease. Treatment depends upon the type of ulcerative colitis diagnosed.
Itching can be a common problem. Itches can be localized or generalized. There are many causes of itching to include: infection (jock itch, vaginal itch), disease (hyperthyroidism, liver or kidney), reactions to drugs, and skin infestations (pubic or body lice). Treatment for itching varies depending on the cause of the itch.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
"Just a spoonful of sugar... " goes the song. But what happens to that sugar once you swallow it? In fact, how is it that you are able to swallow it at all? Your digestive system performs amazing feats every day, whether you eat a double cheeseburger or a stalk of celery. Read on to learn what exactly happens to food as it makes its way through your digestive system.
What Is Digestion?
Digestion is the complex process of turning the food you eat into the energy you need to survive. The digestion process also involves creating waste to be eliminated.
The digestive tract (or gut) is a long twisting tube that starts at the mouth and ends at the anus. It is made up of a series of muscles that coordinate the movement of food and other cells that produce enzymes and hormones to aid in the breakdown of food. Along the way are three other organs that are needed for digestion: the liver, gallbladder, and the ...