Get the Facts About Primary Biliary Cholangitis


Categorized as a chronic autoimmune liver disease, primary biliary cholangitis (PBC) causes swelling and damage in the small bile ducts of the liver. In the event that primary biliary cholangitis goes untreated or undetected, it could cause serious scarring within the liver, liver failure, and liver transplant needs. As such, it is imperative to realize the risk factors and indications of the condition. While PBC was previously known as "primary biliary cirrhosis," PBC patient advocacy groups and medical experts elected to change the name in 2015. Many patients affected by PBC thought that utilizing the word cirrhosis resulted in an erroneous association with alcohol use and was frequently misleading since many people living with primary biliary cholangitis do not have cirrhosis (advanced liver scarring).

Risk factors for PBC

Women over 40 are at the greatest risk for primary biliary cholangitis. It is estimated that the condition impacts one in 1,000 women over the age of 40. Though men can get primary biliary cholangitis as well, nearly 90% of patients who have the liver disease are women. Primary biliary cholangitis may carry a familial link, and a patient could be at an increased risk if they have a parent, sibling, or child who is also impacted by the liver disease. Additionally, a minimum of half of the individuals with PBC also have another autoimmune disease. Patients impacted by health concerns, such as Sjogren's syndrome, autoimmune thyroid disease, and Raynaud's phenomenon, must be particularly cognizant of their medical risk. The exact source of PBC remains unknown, but the liver condition is not caused by drinking alcohol and is not contagious.

The signs of primary biliary cholangitis

Among some individuals, PBC can take many years to present symptoms. A number of primary biliary cholangitis symptoms are a lot like those of other health problems, which can make it difficult for doctors to diagnose the condition. Oftentimes, people with PBC receive a diagnosis when signs of liver damage are detected throughout the course of routine liver tests or labs. Standard laboratory analysis is a general method to identify the function of the liver and often includes analyzing:

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

Among individuals exhibiting symptoms of primary biliary cholangitis, the most frequently observed include fatigue and itching.

How is primary biliary cholangitis identified?

A key health aspect doctors first look at to identify primary biliary cholangitis is an individual's alkaline phosphatase (ALP) level.

  • ALP, at times called "alk phos,” is an enzyme found in the body.
  • An abnormally elevated ALP level can point to damage in the liver.
  • In the initial stages of PBC, abnormally high alkaline phosphatase can serve as an early indication to the medical team that primary biliary cholangitis could have developed.

Additionally, it is imperative to test for AMAs (antimitochondrial antibodies) if primary biliary cholangitis is likely.

  • AMAs are proteins produced by the immune system.
  • The presence of AMAs can signal primary biliary cholangitis.

In certain situations, doctors perform a biopsy of liver tissue to establish a diagnosis of primary biliary cholangitis and to gauge disease progression. But biopsies of the liver are generally not necessary to diagnose PBC.

How is PBC treated?

To date, there is no way to reverse primary biliary cholangitis, but two medications have been approved in the United States to aid in controlling the disease and to help slow down progressive damage to the liver. Medical health standards recommend that healthcare professionals assess ALP amounts in patients who have primary biliary cholangitis at 3 to 6 – month intervals to monitor disease advancement and discern the extent to which any prescribed medication is working. Because PBC is not a common condition, a fair number of people look for treatment from GI doctors and hepatologists who are experts in managing diseases of the liver.

Find help for primary biliary cholangitis in Tulsa, OK

September has been designated as Primary Biliary Cholangitis Awareness Month, and Sunday, September 12th is International PBC Day. This also provides a chance for people who have been diagnosed with the liver issue to commemorate the triumphs of the primary biliary cholangitis community and bring about awareness surrounding PBC. If you or a member of your family may be dealing with primary biliary cholangitis, we urge you to contact Adult Gastroenterology Associates to learn more. You can arrange a consultation with one of our Tulsa, OK gastrointestinal specialists to understand your risk for PBC and find out about alkaline phosphatase testing.