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Liver » Primary Biliary Cholangitis

What Happens When Primary Biliary Cholangitis Festers- the Complications Guide

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Primary Biliary Cholangitis(PBC) is a defect of the bile ducts which eventually leads to liver damage by replacing the sound hepatocytes with scar tissues. This disease may involve your immune system. Thus, curing it becomes a complicated affair.


PBC treatments revolve around reducing the complications, thus bringing the effect of the disease down a notch. The idea behind it is to stall further liver damage as much as possible.

The second-hand damage that PBC extends comes in the form of the following diseases. While your medical care team will do all in their power to help prevent these complications from rising, you must also be aware of the danger and the ways to keep them at bay.


For a reason not entirely clear, PBC could cause your bones to become weak and brittle. A DEXA Scan (bone density measuring X-Ray) becomes a regular event for PBC sufferers to keep tabs on the status of bone strength.

The doctors may suggest you take calcium supplements or vitamin D. they may also ask you to commit to weight bearing exercises, aerobics, dancing, running, etc. on a regular basis.

Portal Hypertension

The portal vein is a bunch of vessels coming out of the stomach, spleen, intestines, pancreas, etc. It branches into the liver as tiny capillaries. The damage PBC causes to the liver makes it difficult for blood to flow through these vessels, causing high blood pressure in the portal venous system.

Since blood needs to find a way from your liver to your heart, large and swollen veins begin appearing along the oesophagus or stomach lining. These veins are called varices.

These varices could rupture any moment, causing internal bleeding and a probably fatal scenario.

Hepatic Encephalopathy

With PBC induced liver damage, the toxin removal system controlled by the organ also gets affected. The poison level increases in your blood and gets accumulated elsewhere (in your brain, for example), thus causing hepatic encephalopathy.

The symptoms include confusion, agitation, disorientation, inability in speaking, muscle tremors, and coma.

Bile Stones and Gallstones

Other than having gallstones in the bile duct, you may also have a solidified clump of bile fluid that is formed when the bile begins backing up in the bile duct. The bile duct stone could cause abdominal pain, jaundice, appetite loss, fever, nausea, clay-coloured stools, and vomiting.

Vitamin Deficiencies

Apart from the Vitamin D deficiency as explained in the Osteoporosis section, PBC may affect the absorption of fat-soluble vitamins, A, E, and K for example.

Bile helps in digesting fats and these vitamins. A disrupted flow of bile and the resulting vitamin deficiency could cause harm to your vision, bone density, nerves, muscle strength, and defence again bleeding and bruising.

Oedema and Ascites

With gradual liver and bile duct deterioration and portal hypertension, fluid collects in the stomach, around the intestines, and in the legs, feet, and ankles. It leads to swelling around each part where fluid has accumulated.

This fluid could get infected (bacterial peritonitis) and can be treated by draining the cavity of the useless liquid.

Cirrhosis and Liver Cancer

Cirrhosis is the most prominent complication of PBC. The bile duct malfunctioning causes liver scarring (i.e. Cirrhosis), and it occurs after PBC has progressed to an advanced stage.

Since the healthy liver tissues are getting destroyed actively because of PBC, it increases your chances of catching cancer causing elements. However, if you have been diagnosed with PBC, the regular blood tests and ultrasounds you’ll get will make a cancer diagnosis more likely. Early detection of cancer may help in better treatment.

And It Doesn't End Here

Since Primary Biliary Cholangitis sports some connection to human immune system defects that the medical world is yet to pinpoint, you are also exposed to other dangerous diseases like thyroid issues, rheumatoid arthritis, Sjogren’s Syndrome, CREST syndrome, etc.

Talk to your doctor and understand how to prevent the possible complications of Primary Biliary Cholangitis better.

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