Primary Sclerosing Cholangitis is most strongly associated with which condition?

• A. Diabetes mellitus
• B. Hepatitis
• C. Peptic ulcer disease
• D. Inflammatory bowel disease

Answer: (D)

Inflammatory bowel disease, particularly ulcerative colitis, is the condition most strongly linked to primary sclerosing cholangitis. PSC is a chronic cholestatic liver disease where inflammation and fibrosis affect the bile ducts, and many patients have concomitant IBD—even if gastrointestinal symptoms aren’t prominent. This association is clinically important because PSC with IBD carries a higher risk of colorectal cancer, so colonoscopic surveillance is routinely recommended. The other conditions listed do not have as strong or consistent a connection with PSC.