Primary biliary cirrhosis
Ifprimary biliary cirrhosis (PBC)is not treated or reaches an advanced stage, it can cause other potentially seriousproblems.
For reasons that are unknown, people with PBC are at an increased risk of developing Osteoporosis . This is a condition in which the bones becomeweak and brittle.
A DEXA scan , which is a type of X-ray that measures the density of your bones, may be carried outwhen you are diagnosed with PBC and regularly thereafter to monitor the condition of your bones.
Your GP may prescribe vitamin D and calcium supplements to help maintain your bone strength.
You may also be advised to exercise regularly, with a particular focus on weight-bearing exercises such as running, dancing and aerobics, because this can help reduce your risk of osteoporosis.
In some cases, you may also need more specific treatment, such as bisphosphonates. This is a medication that slows the rate at which bone is broken down by the body, which can help maintain bone density and reduce the risk of a fracture.
Portal hypertension isincreasedblood pressure inside your liver as a result of damage and scarring ( cirrhosis ), making itharder for blood to move through it.
For your blood to return fromyour liverto your heart,new blood vessels start to open up, usually along the lining of your stomach or oesophagus (the long tube that carries food from the throat to the stomach). These new blood vessels are known as varices.
The walls of these varices are quite fragile and in some cases can split open and bleed.
This can cause gradual, long-term bleeding, which can lead to anaemia (alackofred blood cells), or it can be sudden and severe, causing you to vomit blood and pass stools that are very dark or tar-like.
If you vomit blood or have very dark stools, you shouldgo to your local GPsurgery or yournearest accident and emergency (A&E) department immediately.
Portal hypertension can sometimes be managed with a type of medication known as beta blockers , which can help reduce your blood pressure, although a procedure to seal the varices using an endoscope (a narrow tube with a camera at the end that is passed down your throat) may be recommended in some cases.
If you have portal hypertension, you may also develop a build-up of fluid in your abdomen (stomach) and around your intestines. This fluid is known an ascites.
Initially, this can be treated with water tablets (diuretics). If the problem progresses, many litres of fluid can build-up and this will need to be drained. This is a procedure known as paracentesis and involves a long thin tube being placed into the fluid through the skin under local anaesthetic .
One of the problems associated with ascites is the risk of infection in the fluid (spontaneous bacterial peritonitis ). This is potentially a very serious complication and can be fatal.
One of the most important functions of the liver is to remove toxins from your blood. If your liver is unable to do this due to cirrhosis, the levels of toxins in your blood can increase and lead to a condition called hepatic encephalopathy.
Symptoms of hepatic encephalopathy can include:
Hepatic encephalopathy may require admission to hospital. In hospital, your body functions will be supported while medication is given to remove the toxins from the blood.
Hepatic encephalopathy is very uncommon in PBC and must be distinguished from concentration and memory problems linked to fatigue.
Bile produced by the liver plays an important role in digestion, particularly in digesting fats. As the flow of bile out of the liver is obstructed in people with PBC, the condition may occasionally cause problems absorbing "fat-soluble" vitamins including vitamins A, D, E and K.
The medication colestyramine, often used to reduce the itchinessassociated with PBC, can also affect your body's ability to absorb some of these vitamins from food.
Significant deficiencies in these vitamins can cause problems such as:
If you're not getting enough of one or more of these vitamins, you doctor may recommend taking supplements.
If you have PBC, the progressive damage to your liver slightly increases your risk of developing liver cancer .
Therefore,regular screening may be recommended to look for signs of cancer because the earlier the cancer is diagnosed, the greater the chance there is of curing it.
Screening willtypically involve regular ultrasound scans and blood tests .
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Primary biliary cirrhosis (primary biliary cholangitis) is a long-term liver disease in which the bile ducts in the liver become damaged.
Primary biliary cirrhosis (PBC) often doesn't cause any symptoms in the early stages.
The exact cause of primary biliary cirrhosis (PBC) is unknown, although it is widely thought to be the result of a problem with the immune system.
In many cases, a suspected diagnosis of primary biliary cirrhosis (PBC) is made after having a blood test for another, unrelated condition.
The aim of treatment for primary biliary cirrhosis (PBC) is to prevent liver damage as much as possible and reduce your symptoms.
If primary biliary cirrhosis (PBC) is not treated or reaches an advanced stage, it can cause other potentially serious problems.