What causes pbc liver disease?

Liver disease is not exactly anyone’s favourite topic of conversation, unless you are a hepatologist. However, if you are reading this article, then chances are that either you or someone close to you has been diagnosed with PBC liver disease. Don’t panic! In this article, we will be talking about what causes Primary Biliary Cholangitis (PBC), why it happens and how doctors have devised ways of treating the condition over the years.

The Three Letters Nobody Wants To Hear

PBC stands for Primary Biliary Cholangitis. It used to be referred to as Primary Biliary Cirrhosis but was changed in 2016 because cirrhosis isn’t always present in patients with this condition. Before we dive into what causes PBC/Primary Biliary Cholangitis/Pregnant Bear Cub(let’s just go with PBC from now on), let us first understand what it is.

If at any point throughout our journey together, things get too technical/boring/dry for your taste buds – I won’t hold it against you if your mind wanders off to thoughts about grilled cheese sandwiches instead.

A Quick Introduction To Your New Friend: The Liver

The liver is one of those organs hiding away doing its thing without much acknowledgement from most individuals except when something goes wrong (like a hangover).

Let’s Get Physical

For my fellow visual learners who pay more attention to pictures than words; take a look:

Liver Diagram

The liver plays an important role in an individual’s overall health and wellbeing by helping remove toxins from the body while producing bile which helps digest fats within our foodstuff.

It also produces glucose which fuels most parts of our body – considered like putting gas/fuel back into our cars. It stores vitamins/minerals for later use, helps control blood sugar levels, inactivates hormones, and synthesises proteins just to name a few of its crucial functions.

So What Is PBC And How Does It Affect The Liver?

PBC is an autoimmune disease that damages bile ducts. Bile ducts are tubes within our liver which move the bile produced out into the hepatic veins (the largest veins leading from the liver).

Autoimmune diseases occur when infection-fighting cells get confused and attack healthy tissue instead – kind of like a defensive player tackling his own teammate instead of opposing team members.

Over time as these attacks continue to happen; inflammation/fibrosis may occur around/damage openings between these bile ducts (they’re referred as portal tracts) impairing how efficiently they function. At this point – hang on to your hats folks – cirrhosis may develop over many years (\~20% chance) following continued damage/scarring occurring within liver tissue((“which makes it harder for everything in there since some parts have been replaced by fibrousmaterial degrading functionality”)).

Risk Factors For Developing PBC

While medical researchers haven’t discovered why PBC occurs yet – several risk factors have been recognised including:

  1. Being female
  2. Age 30-60
  3. Genetic predisposition(a fancy way of saying having certain genes inherited at birth increases your probabilities)
  4. Environment(although no specific toxins/contaminants are currently confirmed)

Most patients diagnosed with progressive symptoms belong to category one/three above majority being women compared to men(\~9:1 ratio) whilst category two applies across both genders(([10.High Importance] West J Med-v148n6p646.pdf))

Now you might be thinking “Hold up…can’t my body heal itself?”
That’s true! In fact most people with PBC live a relatively healthy life with no visible symptoms.

Symptoms Of PBC

The early stages of the disease occur without obvious indicators whatsoever, however as damage to the liver progresses over time, people frequently become aware of certain signs which include:

  • Fatigue
  • Itching
  • especially at night
  • Dry Mouth/eyes/throat due to having less saliva/tears being insufficiently produced.
  • Abdominal pain/discomfort towards top right-hand side.
  • Yellowing white part of eyes/skin (‘jaundice’) although this isn’t always present.

Warning Warning: This is technical bit coming through so you might want to skip if not interested!

Symptoms may also include high levels of alkaline phosphatase (elevated ALP) and other markers being detected in blood tests for fat/lipid absorption within diet originating from products such as fish oils/butter etc.

This cocktail combination of both clinical/personal history/blood results alongside radiological imaging confirms that the most probably cause underscores consideration because there aren’t any specific findings indicative for diagnosis otherwise(think trying on different outfits until finding perfect fit).

What Can You Do About It?

While there are currently no cures available for autoimmune diseases like PBC – numerous methods can help control/manage them. Ursodeoxycholic acid (UDCA), Obeticholic acid(OBET) and budesonide/alprazolam have been successful in slowing down symptoms when taken regularly under medical guidance(Don’t try self-medicating please!)

In more severe cases; liver transplants offer best chance improvement(If indicated). As with all potential treatment plans identifying underlying risk factors/preventing further scarring progression is crucial step while monitoring ongoing health status regularly (more frequent monitoring beyond normal approximately every six months or annually) helps detect any possible complications sooner than later.

Don’t succumb to the internet and self-diagnose; If in doubt, always seek professional medical advice because your liver is not a Laughing matter!

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