Should I Be Concerned About Primary Biliary Cholangitis?


Classified as a progressive autoimmune disease, primary biliary cholangitis (PBC) causes damage and inflammation in the small bile ducts within the liver. If PBC is not treated or detected, it may lead to serious liver scarring, liver failure, and the need for a liver transplant, making it vital to realize the risk factors and warning signs concerning the condition. PBC was once known as "primary biliary cirrhosis" but PBC medical experts and patient advocacy groups changed the name in 2015. Many patients affected by the disease thought that referring to it as cirrhosis resulted in an erroneous association with alcohol use and was often deceptive, as most people living with primary biliary cholangitis are not impacted by cirrhosis of the liver.

Am I at risk for primary biliary cholangitis?

Women who are middle-aged are at the greatest risk for developing PBC. In fact, it is estimated that the condition impacts one in 1,000 women over the age of 40. While men can develop the condition as well, nearly 90% of patients who have the disease are women. Primary biliary cholangitis may affect members of the same family, and you could be at an increased risk if you have a sibling, parent, or child who also has the liver disease. Additionally, no less than 50% of people with PBC have also been diagnosed with another autoimmune disease. Those affected by medical concerns, such as Raynaud's syndrome, autoimmune thyroid disease, and Sjogren's syndrome, ought to be exceptionally aware of their medical risk. The precise cause of PBC is not known, but primary biliary cholangitis is not transmissible and the condition is not a result of consuming alcohol.

Signs of PBC

Among some individuals, PBC symptoms can take many years to present. A number of symptoms of the disease are similar to those of other health conditions, which can make it difficult for doctors to diagnose. Commonly, patients with PBC are diagnosed because their liver shows signs of damage throughout the course of routine liver lab testing. Standard lab tests are a routine way to see how well the liver is functioning and may include measuring markers, like:

  • bilirubin
  • gamma-glutamyl transpeptidase (GGT)
  • prothrombin time (PT)
  • albumin
  • alanine aminotransferase (ALT)
  • alkaline phosphatase (ALP)
  • aspartate aminotransferase (AST)

In patients showing signs or symptoms of PBC, the most frequently reported indications include exhaustion and itching (sometimes called pruritus).

How is primary biliary cholangitis identified?

An essential health aspect doctors first review to identify primary biliary cholangitis is the body's alkaline phosphatase (ALP) amounts.

  • ALP, which is occasionally called "alk phos,” is an enzyme present in the body.
  • In the initial stages of PBC, unusually high alkaline phosphatase can be an early indication to physicians that primary biliary cholangitis may be occurring.
  • An unusually elevated ALP level could point to liver damage.

It is also vital to screen for AMAs (antimitochondrial antibodies) in cases where PBC may be present.

  • The presence of AMAs can signal PBC.
  • AMAs are substances produced by the body's immune system.

In certain situations, doctors carry out a biopsy of liver tissue to corroborate a PBC diagnosis and to study disease progression. However, biopsy procedures are generally not required to diagnose PBC.

How is primary biliary cholangitis treated?

As of right now, there is no way to reverse primary biliary cholangitis; however, two medications have been approved in the United States to help control the disease and slow the further advancement of liver trauma. Healthcare guidelines recommend that physicians assess ALP amounts in people with PBC at 3 to 6-month intervals to assess the progression of the disease, observe the degree of effectiveness, and determine how well the medication is helping. Because primary biliary cholangitis is a rare medical concern, a large number of people receive treatment from gastrointestinal physicians and hepatologists who specialize in managing conditions involving the liver.

Find hope and support in your Phoenix, AZ community

September is PBC Awareness Month, and Sunday, September 12th is International Primary Biliary Cholangitis Day. In the event you think you or a family member might be experiencing PBC, now is a great time to learn more about this condition. This also creates the opportunity for individuals who have the condition to celebrate the successes of the primary biliary cholangitis community and raise the understanding regarding this liver disease. Get in touch with Arizona Digestive Health today to set up a visit with one of our Phoenix, AZ gastroenterologists. Our caring team can help you learn about your risk for PBC and determine if alkaline phosphatase testing is the next step.