PBC: symptoms & diagnosis
What are the symptoms of Primary Biliary Cholangitis?
Some people with PBC will never get any symptoms of the disease but some people may experience the following.
Clear symptoms of PBC:
Constant tiredness (for some people this can be severe) and intense itching in any part of the body. Itching, also known as pruritus, may be a result of your liver’s inability to process bile. It is thought that bile acids are not the cause of the itching but rather other chemicals that are retained in the body. As with tiredness, the severity of the itching will vary from person to person. Severity is not an indication of the amount of liver damage.
Other symptoms that may develop usually include the following:
Tiredness and itching are generally the first symptoms to appear while jaundice is usually associated with the later stages of the disease.
How is Primary Biliary Cholangitis diagnosed?
Doctors can tell whether you have PBC on the basis of symptoms and a range of tests, including blood tests.
Liver function test for Primary Biliary Cholangitis (PBC)
This type of test is performed to gain an idea how the different parts of your liver are functioning. The Liver Function Tests are made up of a number of separate examinations, each looking at different properties of your blood.
In PBC, doctors will be looking for increased levels of both alkaline phosphatase (ALP), an enzyme released into the blood by damaged bile ducts, and the immunoglobulin IgM. The liver enzymes alanine transaminase (ALT) and aspartate transaminase (AST) are also monitored, although these are a measure of any leakiness or damage relating primarily to liver cells rather than the bile duct cells
Ultrasound scan for Primary Biliary Cholangitis (PBC)
This is used to check the condition of the bile ducts and to rule out the possibility that your symptoms could be a sign of a different liver problem.
Liver biopsy for Primary Biliary Cholangitis (PBC)
If tests show you have PBC you may need a liver biopsy to see how serious the condition is.
Treatment for Primary Biliary Cholangitis
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 common reason for liver transplants in the UK.
Managing your condition
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.
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.
Further Information
Complementary and alternative medicines
Many complementary and alternative medicines are available that may ease the symptoms of liver disease. But certain medications used in non-liver related disease can damage the liver. At present, healthcare professionals are not clear on the role and place of some therapies in managing liver disease. More research needs to be done on the use of these therapies. You may wish to discuss the use of these therapies with your doctor.
UK-PBC Project
UK-PBC is a collaborative venture between NHS Trusts across the UK, patient groups and UK and international companies, aimed at improving our understanding of PBC and the way it impacts on the lives of patients.
http://www.uk-pbc.com
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