What Are the Health Risks of Primary Biliary Cholangitis?

primary biliary cholangitis

September is Primary Biliary Cholangitis Awareness Month, and Sunday, September 12th is International Primary Biliary Cholangitis Day. Classified as a progressive autoimmune liver disease, primary biliary cholangitis (PBC) leads to swelling and damage in the small bile ducts in the liver. In the event that PBC goes untreated or undetected, it could result in serious scarring of the liver, liver failure, and liver transplant needs, making it essential to understand the risk factors and indications associated with the disease.

The condition was once known as "primary biliary cirrhosis." However, PBC medical experts and patient advocacy groups decided to change the name in 2015. Many individuals impacted by the condition believed that using the word cirrhosis led to an erroneous connection with the use of alcohol and was misleading given that many patients living with primary biliary cholangitis do not have severe liver damage (cirrhosis).

Who is affected by primary biliary cholangitis?

Women over 40 are at the greatest risk for PBC. As a matter of fact, it is estimated that the condition impacts one out of every 1,000 women over the age of 40. Men can develop primary biliary cholangitis as well, but approximately 90% of patients who have the liver condition are women. Primary biliary cholangitis may be prevalent within some families, and a person might be at a higher risk if they have a parent, sibling, or child who has been diagnosed with PBC. In addition, a minimum of half of the patients with PBC additionally have another autoimmune disease. People who are living with medical problems, such as Raynaud's phenomenon, autoimmune thyroid disease, and Sjogren's syndrome, should be particularly conscious of their health risks. The exact cause of primary biliary cholangitis is not understood, but primary biliary cholangitis does not result from consuming alcohol and it is not a communicable disease.

The signs of primary biliary cholangitis

Primary biliary cholangitis can take years to exhibit symptoms. A number of PBC symptoms are common to other health problems, causing it to be harder for physicians to identify. In many cases, patients with primary biliary cholangitis receive a diagnosis when indications of liver damage are identified through routine liver testing. Routine laboratory analysis is a general way to evaluate liver function and often consists of measuring:

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

Fatigue and itching (pruritus) are the most commonly reported symptoms among individuals diagnosed with primary biliary cholangitis.

How is primary biliary cholangitis identified?

One critical health aspect physicians first asses to detect PBC is a person's ALP (alkaline phosphatase) readings.

  • ALP, sometimes called "alk phos,” is an enzyme found in the body.
  • An abnormally high level of ALP can be a sign of liver damage.
  • During the early stages of PBC, abnormally high ALP could be an early warning sign to healthcare practitioners that PBC might be present.

Testing for antimitochondrial antibodies (AMAs) should also be performed in cases where PBC is suspected.

  • Antimitochondrial antibodies are proteins produced by the body's immune system.
  • The presence of antimitochondrial antibodies is an indicator of primary biliary cholangitis.

In some instances, doctors carry out a liver tissue biopsy to ascertain a diagnosis of PBC and to evaluate disease progression. But biopsies of the liver generally are not necessary to diagnose primary biliary cholangitis.

What are treatment options for primary biliary cholangitis?

As of right now, there is no cure for primary biliary cholangitis. However, two medications have been approved for use in the United States to help control the condition and slow the advancement of liver trauma. Healthcare recommendations propose that doctors evaluate ALP ranges in individuals with primary biliary cholangitis every 3 to 6 months to monitor the advancement of the disease and understand the extent to which medication therapy is working. Since PBC is not a common medical disease, many individuals request care from gastroenterologists and liver specialists who have advanced training in treating conditions involving the liver.

Get care for primary biliary cholangitis in New Orleans, LA

Primary Biliary Cholangitis Awareness Month provides a chance for patients who have been diagnosed with the liver condition to commemorate the successes of the PBC patient community and raise education regarding this liver disease. If you or a member of your family might be at risk for primary biliary cholangitis, we would love to help you to understand this condition. Get in touch with Metropolitan Gastroenterology Associates today to schedule a visit with one of our New Orleans, LA gastroenterologists. Our experienced team can determine if you are at risk for primary biliary cholangitis and whether you might benefit from ALP testing.