There are a number of treatments for the symptoms of PBC. Some of them help with any unpleasant symptoms, such as dry eyes, and others slow the progress of the disease.
At this time, doctors cannot cure PBC or completely stop its slow destruction of the bile ducts. Because of this PBC is a major reason for liver transplants in the UK.
Managing unpleasant symptoms
Itching skin: colestyramine (sold as Questran) may be prescribed by your doctor to help ease itching. Taken orally, colestyramine works by preventing re-absorption of the chemicals that cause the itching. It can take days or even weeks before this becomes effective.
Some people taking colestyramine have problems such as changed bowel habits and bloating. Your doctor may prescribe 'Questran light' to reduce these side effects.
If colestyramine does not help, a hospital specialist may try other medicines such as
rifampicin and naltrexone.
Itching is made worse by dry skin. It is very important to use plenty of moisturiser. If you're running a bath, don't make it too hot.
Dry eyes and dry mouth: the combination of dry eyes and a dry mouth (sicca syndrome) might be soothed by such treatments as artificial tears and saliva, lubricating gels and oestrogen creams. You may find that lozenges from your pharmacist will help with the dryness in your mouth.
Controlling your condition
A medication called ursodeoxycholic acid (URSO, also referred to as UDCA) has helped some people. Made from naturally occurring bile acid, it seems to work through several mechanisms by protecting the liver from the harmful chemicals in the bile.
Although early studies failed to show any direct impact on survival rates, new evidence suggests that URSO may help to keep people alive for longer and delay liver transplantation.
A number of other medicines are also now being tried and your medical team may ask for your assistance in this. At present, however, a liver transplant is the only option for people who have advanced PBC.
Will I need a liver transplant?
A liver transplant is usually only recommended if other treatments are no longer helpful and your life is threatened by end stage liver disease. It is a major operation and you will need to plan it carefully with your medical team, family and friends.
However, liver transplantation works well for people with PBC. It is possible to get PBC in your new liver, but it may take up to 15 years before the disease becomes significant.