What Is Primary Biliary Cirrhosis?
Primary biliary cirrhosis (PBC) is a chronic autoimmune liver disease in which the small bile ducts within the liver become inflamed, progressively damaged, and blocked. Over time, bile builds up in the liver, leading to liver cell injury and scarring. Early diagnosis and treatment can slow disease progression and preserve liver function.
Common Causes and Risk Factors
- Autoimmune reaction against the bile ducts
- Being a woman, especially between ages 40 and 60
- Family history of primary biliary cirrhosis
- Presence of other autoimmune diseases (e.g., thyroid disease, Sjögren's syndrome)
Signs and Symptoms
- Often none in the early stages
- Fatigue and general weakness
- Itchy skin (pruritus), often worse at night
- Dry eyes or dry mouth
- Pain or discomfort in the upper right abdomen
- Jaundice (yellowing of the skin and eyes)
- Dark urine and pale-colored stools
How Dr. Nghia Nguyen Diagnoses Epigastric Pain in Primary Biliary Cirrhosis?
Dr. Nguyen follows a structured, step-by-step approach:
Medical History and Physical Exam
He reviews your symptoms—especially epigastric pain—along with fatigue, itching, and risk factors such as age, gender, family history of PBC, and other autoimmune conditions.
Blood Tests
We measure liver enzymes (ALP, AST, ALT), bilirubin, and antimitochondrial antibodies (AMA) to detect PBC and assess liver function.
Imaging Studies
- Abdominal ultrasound to evaluate bile-duct dilation and liver texture.
- Magnetic resonance cholangiopancreatography (MRCP) for detailed bile-duct mapping.
Endoscopic Evaluation (for Epigastric Pain)
Upper endoscopy may be performed to rule out peptic ulcer disease or gastritis as contributors to your epigastric discomfort.
Advanced Testing (if needed)
A liver biopsy can confirm the diagnosis, stage inflammation and fibrosis, and guide long-term treatment planning.
Frequently Asked Questions
What is primary biliary cirrhosis?
Primary biliary cirrhosis (PBC) is a long-term liver condition in which small bile ducts become inflamed, damaged, and blocked over time.
What are the common symptoms of PBC?
Early on, many people have no symptoms. As PBC progresses, you may experience fatigue, itchy skin, dry eyes or mouth, upper-right abdominal pain, jaundice, dark urine, or pale stools.
How is PBC diagnosed?
Diagnosis is based on blood tests (liver enzymes and antimitochondrial antibodies), imaging studies (ultrasound or MRI), and sometimes a liver biopsy to assess damage.
What treatment options are available?
Treatment typically includes ursodeoxycholic acid (UDCA) to improve bile flow, obeticholic acid if UDCA is insufficient, medications for itching, and vitamin supplements to prevent deficiencies.
Can diet and lifestyle changes help?
Yes. A balanced, low-fat, high-fiber diet, regular exercise, and avoiding alcohol can support liver function and reduce symptoms.
Will I need a liver transplant?
Most patients manage PBC with medication and lifestyle modifications. A liver transplant is considered only in cases of severe, advanced liver damage.
How often should I follow up with my doctor?
Follow-up visits are generally scheduled every 3 to 6 months, depending on your symptoms and liver test results.
