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Primary Biliary Cirrhosis
Primary biliary cirrhosis (PBC) is a chronic liver disease damaging bile ducts, leading to bile buildup and scarring. At GastroDoxs in Houston, Dr. Scott provides expert diagnosis, personalized treatment plans and care to slow disease progression and protect your liver.
Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.
What Is Primary Biliary Cirrhosis?
Primary biliary cirrhosis (PBC) is a chronic, autoimmune liver disease in which the body's immune system progressively destroys the small bile ducts inside the liver. When these ducts become inflamed and scarred, bile can't flow normally, leading to bile accumulation, liver cell damage, and eventual fibrosis. Early recognition and treatment can slow disease progression and help preserve liver function.
Common Causes and Risk Factors
Autoimmune attack on the small intrahepatic bile ducts
Female gender, most often between ages 40 and 60
Family history of PBC or other autoimmune diseases
Genetic predisposition or certain HLA gene variants
Signs and Symptoms
Fatigue or persistent tiredness
Itchy skin (pruritus), often worse at night
Dry eyes and/or dry mouth (sicca symptoms)
Jaundice (yellowing of the skin and eyes)
Discomfort or fullness under the right rib cage
How Dr. Scott Diagnoses Primary Biliary Cirrhosis (PBC)
Dr. Scott uses a step-by-step approach:
Medical History and Exam
He reviews your overall health history and risk factors, then asks detailed questions about your epigastric pain-its timing, relation to meals, and any accompanying symptoms-and performs a focused abdominal exam.
Blood Tests
We measure liver enzymes (ALP, ALT, AST), bilirubin levels, and antimitochondrial antibodies (AMA) to detect PBC. If epigastric discomfort suggests ulcer disease, we may also test for H. pylori.
Imaging Studies
Abdominal ultrasound checks liver size, bile ducts, gallbladder, and looks for stones or duct dilation.
MRCP (magnetic resonance cholangiopancreatography) gives detailed views of the biliary tree and pancreas to spot strictures or blockages.
Endoscopy and ERCP (if needed)
An upper endoscopy evaluates the stomach and duodenum for ulcers or gastritis causing epigastric pain. ERCP can both visualize and treat narrowed bile ducts in PBC.
Liver Biopsy (if needed)
When noninvasive tests are inconclusive, a liver biopsy confirms PBC and assesses the degree of inflammation and scarring.
Treatment
Our Team offers a full range of care for primary biliary cirrhosis.
1. Lifestyle and Diet Modifications
Balanced diet rich in fruits, vegetables, lean proteins, and whole grains to support liver function
Avoidance of alcohol to prevent further bile duct injury
Customized exercise and stress-management plan, including walking, yoga, and relaxation techniques
2. Medications
Ursodeoxycholic acid to improve bile flow and slow disease progression
Obeticholic acid for patients needing additional bile-duct support
Symptom-focused therapies to relieve itching and correct vitamin deficiencies
3. Minimally Invasive or Advanced Procedures
Endoscopic Retrograde Cholangiopancreatography (ERCP) to open blocked bile ducts
Liver biopsy for precise assessment of inflammation and scarring
Evaluation and preparation for liver transplantation in advanced cases
Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.
Frequently Asked Questions
What is primary biliary cirrhosis?
Primary biliary cirrhosis (PBC) is a chronic liver disease in which small bile ducts become inflamed and damaged, causing bile to build up and scar the liver.
What causes primary biliary cirrhosis?
PBC is thought to be an autoimmune disorder where the body's immune system mistakenly attacks its own bile ducts.
What symptoms should I watch for?
Early signs include persistent fatigue, itchy skin (especially at night), dry eyes or mouth, jaundice (yellowing of skin or eyes), and right-side rib discomfort.
How is PBC diagnosed?
Diagnosis involves blood tests for liver enzymes and antimitochondrial antibodies, imaging studies such as ultrasound or MRI, and occasionally a liver biopsy.
What are the treatment options?
Treatment may include ursodeoxycholic acid or obeticholic acid to improve bile flow, medications for symptom relief, lifestyle modifications, ERCP for ductal blockage, and liver transplant in advanced cases.
Can diet and exercise help manage PBC?
Yes. A balanced diet with fruits, vegetables, lean proteins, whole grains, regular gentle exercise, and abstaining from alcohol support liver health.
When should I see a liver specialist in Houston?
If you experience unexplained fatigue, persistent itching, abnormal liver test results, or any symptoms suggestive of PBC, schedule an evaluation with a hepatologist promptly.
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