@cleoreads All of my liver and chronic UC started pretty much at the same time. The PSC showed in high enzyme levels during a routine physical. They did a number of procedures and one was a sigmoidoscopy. This showed the colon issues. The liver enzymes stayed high and the doctor I was referred to didn't really take and action. Just avoid alcohol which I did for almost a year with no change in enzymes. My healthcare was an HMO and I finally got a referral to a GI and he did another sigmoidoscopy and confirmed the UC problems. He brough up the possible tie between PSC and UC. When I relocated from AZ to CO I got better healthcare and better doctors. The confirmation of the small duct PSC and the chronic UC. I had my colon removed about 12 years ago in a procedure that includes the creation of a small internal pouch. It was about at this time that my enzyme levels went back into the normal range.