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Patient education: Primary biliary cholangitis (primary biliary cirrhosis) (The Basics)

Patient education: Primary biliary cholangitis (primary biliary cirrhosis) (The Basics)

What is primary biliary cholangitis? — Primary biliary cholangitis (or "PBC") is a disease that damages the liver. The liver is a big organ in the upper right side of the belly (figure 1). PBC happens when the body's infection-fighting system, called the "immune system," attacks the liver. It used to be called "primary biliary cirrhosis."

PBC is a serious disease. It can scar the liver and make it stop working. This can cause death. Most people who get PBC are females, but males sometimes get it.

What are the symptoms of primary biliary cholangitis? — Some people with PBC have no symptoms. When symptoms do happen, they can include:

Feeling very tired – People who have PBC are often sleepy in the daytime, even if they slept at night.

Itching – This can be worse at night, if a person wears tight or itchy clothes, or in hot weather.

Skin changes – These can include:

Dry skin

Hives – These are puffy patches that happen where a person scratches or rubs the skin.

Dark patches on the skin

Yellow color of the skin and whites of the eyes – This is called "jaundice."

Pain in the joints

Dry eyes and mouth

Belly pain (on the upper right side of the belly)

Losing weight without trying

Memory and thinking problems

Is there a test for primary biliary cholangitis? — Yes. The doctor or nurse will ask about your symptoms and do an exam. Tests include:

Blood tests – This test can show if PBC or another condition is causing the symptoms.

Liver biopsy – For this test, a doctor puts a needle into your liver and takes out a small sample of tissue. Then, they look at it under a microscope. The sample helps doctors make sure PBC is the cause of symptoms. It also tells doctors how much damage there is.

Some people have imaging tests, such as an X-ray or MRI. Imaging tests create pictures of the inside of your body.

How is primary biliary cholangitis treated? — Doctors treat PBC with medicines to slow down the liver damage.

Other treatments include:

Vitamins – Some people with PBC do not get enough of certain vitamins from food. If you are not getting enough vitamins, the doctor can tell you which vitamins to take and how much. Do not take any vitamins or medicines without talking to your doctor or nurse first.

Medicines to treat health problems caused by PBC, such as itching or anemia (having too few red blood cells).

Liver transplant – If your PBC is severe, or the medicines to slow down liver damage do not work, you might need a new liver. During a transplant, a doctor does surgery to replace the damaged liver with a healthy one. After a transplant, PBC sometimes comes back again. You can take medicine to lower the chance of this happening.

Ask your doctor if you might need a liver transplant for PBC. If you do, your doctor will do more tests to make sure you are healthy enough for this kind of surgery. Then your doctor will put you on a waiting list for a liver transplant. Liver transplants are given to people with the most damaged livers first.

More on this topic

Patient education: Cirrhosis (The Basics)
Patient education: Liver transplant (The Basics)

Patient education: Liver biopsy (Beyond the Basics)
Patient education: Hives (urticaria) (Beyond the Basics)

This topic retrieved from UpToDate on: Jan 02, 2023.
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