Primary Biliary Cirrhosis
Primary biliary cirrhosis (PBC) is a chronic condition inside the liver. It is swelling in a part of the liver called bile ducts. Over time, this swelling can cause permanent damage to the bile ducts.
The liver creates a fluid called bile. The fluid is sent out of the liver through bile ducts. The bile then moves to the gallbladder and the small intestine. Bile helps break down food in the intestines. PBC makes it difficult for bile to move out of the liver. The bile is not able to pass through the damaged bile ducts. As a result, the bile backs up into the liver. This leads to liver damage.
The exact cause of PBC is unknown. However, because 95% of patients have specific autoantibodies, it may be due to an autoimmune disorder. This means the immune system is attacking health tissue.
Factors that increase your chance of getting PBC include:
Symptoms of PBC include:
- Itchy skin
- Abdominal pain, especially in right upper abdomen
Signs of liver damage:
- Yellowing of the skin and/or eyes known as jaundice
- Spider veins
- Xanthelasma—yellow deposits around eyelids
Your doctor will ask about your symptoms and medical history. A physical exam will be done. Blood tests will help to determine the extent of liver problems. They may also help look for causes like a hepatitis infection or autoimmune disorder. A liver biopsy will also help determine how much liver damage has occurred.
Detailed pictures of the bile ducts may be needed. To get these pictures, your doctor may order:
There is no known cure for PBC. However, a variety of treatments may help to manage symptoms. Treatment can also help to slow the progression of liver damage and reduce the possibility of complications.
Talk with your doctor about the best treatment plan for you. Treatment options may include:
Certain medications may help control itching. Ursodeoxycholic acid may also help to move bile through the bile ducts.
Your doctor may recommend vitamin supplements. The low levels of bile may make it difficult for your body to breakdown food. As a result, you cannot get enough vitamins from food. Vitamins A, D, K, and calcium are commonly recommended.
A healthy, well-balanced diet helps your overall health. Your doctor may recommend supplements if you are having trouble reaching your nutrition goals. You should also avoid raw shellfish if you have cirrhosis.
Avoid alcohol or other items that can affect your liver. Talk to your doctor about any medications you are taking. Even some over-the-counter medications can be harmful with cirrhosis.
A liver transplant is the only complete cure for PBC. It is only considered when other treatments are unable to control symptoms.
The exact cause of PBC is unknown, so there are no clear steps for prevention.
American Liver Foundation
National Digestive Diseases Information Clearinghouse
Canadian Digestive Health Foundation
Canadian Liver Foundation
Heathcote JE. Management of primary biliary cirrhosis. Hepatology. 2000;31:1005-1013. Available at: http://www3.interscience.wiley.com/cgi-bin/abstract/106596779/abstract. Accessed May 28, 2013.
Lindor KD, Gershwin ME, et al. Primary biliary cirrhosis. Hepatology. 2009; 50:291.
Metcalf JV, Howel D, et al. Primary biliary cirrhosis: epidemiology helping the clinician. Br Med J. 1996;312:1181-1182. Available at: http://bmj.bmjjournals.com/cgi/content/full/312/7040/1181. Accessed May 28, 2013.
Poupon RE, Balkau B, et al. A multicenter, controlled trial of ursodiol for the treatment of primary biliary cirrhosis. UDCA-BPC Study Group. N Engl J Med. 1991; 324:1548-1554.
Primary biliary cirrhosis. American Liver Foundation website. Available at: http://www.liverfoundation.org/abouttheliver/info/pbc/. Updated October 4, 2011. Accessed May 28, 2013.
Primary biliary cirrhosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 11, 2013. Accessed May 28, 2013.
Primary biliary cirrhosis. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/primarybiliarycirrhosis/index.aspx. Updated April 30, 2012. Accessed May 28, 2013.
Last reviewed March 2014 by Daus Mahnke, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.