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For further information and appointments please see the below contact numbers:

For Mr Rob Hutchins:

020 7234 2940

For the following Consultants:

020 7234 2730

Professor Nigel Heaton
Mr Parthi Srinivasan
Mr Andreas A. Prachalias
Dr Phil M. Harrison
Dr Michael Heneghan

Primary Biliary Cirrhosis (PBC) treatment London

What is Primary Biliary Cirrhosis

PBC is a condition which affects the bile ducts and which slowly damages the bile ducts in the liver. In time, the flow of bile is restricted and bile builds up in the liver. This damages liver cells which in some cases leads to cirrhosis. Common early signs of liver damage are itching and tiredness. Other cirrhosis symptoms develop as the disease progresses. Medicines which aim to ease symptoms and slow the progression of the disease may be used. A liver transplant may be needed if the liver becomes badly damaged.

Bile is made by cells in the liver, and is a yellow liquid that contains various chemicals and bile salts. Bile helps to digest food, particularly fatty foods.

Liver cells pass out of the bile into tiny tubes called bile ducts. There is a network of bile ducts throughout the liver. They join together (like the branches of a tree) to form the larger ‘common bile duct’. Bile constantly drips down the tiny bile ducts, into the common bile duct, and into the duodenum (part of the gut - the first part of the small intestine). The gallbladder lies under the liver, it is like a pouch that comes off the common bile duct, and fills with bile, it is like a reservoir that stores bile. The gallbladder squeezes when we eat. This empties the stored bile back into the common bile duct, and out into the duodenum.

In primary biliary cirrhosis, inflammation develops around the small bile ducts within the liver and this inflammation can slowly damage the bile ducts, with the ducts gradually becoming blocked due to the inflammation and damage.

Bile is not able to flow down any ducts that become blocked. This process tends to worsen very slowly, as the number of damaged and blocked bile ducts gradually increases. If bile cannot flow down bile ducts, the bile builds up in the liver cells. In time, the liver cells also become damaged by the accumulation of bile and it may also spill into the bloodstream.

As liver cell damage becomes worse, scarring may develop in the liver and this can cause liver failure. However this only occurs during the later stage of the disease and not everybody develops cirrhosis at the same rate. Additionally not all patients with PBC go on to develop cirrhosis.

Symptoms of primary Biliary Cirrhosis

Although some PBC patients may not have any symptoms. Others may have any or all of the following:

  • Chronic fatigue and lethargy
  • Dark urine and/or pale stools
  • Diarrhoea
  • Dry eyes and mouth
  • Easy bruising
  • Frequent indigestion and/or nausea with poor appetite
  • Intense itching of the skin
  • Jaundice
  • Mottled palms

Treatment of Primary Biliary Cirrhosis

The treatment of choice is Ursodeoxycholic Acid- in the correct dosage according to the patient’s weight. It is also important to keep to a healthy and well balance diet.

The intense itching can be relieved with appropriate medication and if a bile infection is diagnosed then antibiotics can be prescribed. Ultimately it may be necessary for the patient to undertake liver transplantation.

Since there is no cure for PBC, it is of vital importance that regular follow up with liver function tests and liver ultrasound are maintained over at least six monthly intervals.