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Many
liver syndromes are autoimmune and easily and permanently treatable
please read our e-book for permanent cures.
In primary biliary cirrhosis (PBC) the bile ducts in the
liver are attacked by the bodys own immune system.
Bile ducts are tiny tubes in the liver that remove bile and
send it to the gallbladder, . Bile usually works to break up the fat
in food into small droplets, and helps the body to absorb vitamins
A, D, E and K from our diet, so it plays an important part in
digestion.
When the bile ducts are attacked, they are damaged and swell, and
cannot carry out these functions properly. It also means that toxic
(poisonous) substances, which are normally excreted from the body
through the bile, are instead kept inside the liver. These
substances, such as bile acids and minerals, lead to further damage
to the bile ducts and the liver tissue.
The liver can normally heal itself without scarring, but if the
damage is continuous and severe, the regrowth process goes wrong and
scarring occurs, meaning the liver cannot function properly. This
severe damage is known as cirrhosis.
Despite its name, not everybody with primary biliary cirrhosis
actually progresses to cirrhosis, because this condition often
happens very slowly and with no symptoms for years.
Cirrhosis is not always, as is often assumed, related to the
over-consumption of alcohol. It often has quite different causes
such as inherited liver diseases. However, those with PBC can often
not tolerate alcohol because their liver no longer processes it
properly.
Primary biliary cirrhosis is a cholestatic condition (tending to
diminish or stop the flow of bile). Because the bile can no longer
break down fatty substances fully, it is frequently associated with
high levels of cholesterol in the blood, which can be a risk factor
for heart disease, and may lead to liver failure. Because the liver
cannot carry out its usual functions, there are many other potential
complications such as osteoporosis.
Women are nine times more likely than men to have this condition,
and it most commonly appears between the ages of 30 and 60.
Symptoms of primary biliary cirrhosis include:
Extreme tiredness, Itchiness (pruritus), Lack of appetite. Nausea,
Joint or bone pain. Arthritis. Pain over the liver (the upper right
hand side below the ribs).
Skin changes such as blotchiness, or jaundice (when the skin and
the whites of the eyes turn a yellowish colour). Dryness in the
mouth or eyes . Diarrhea, Sometimes there are no symptoms,
especially if it is mild PBC may be discovered accidentally, for
example during a routine blood test.
Cause: The immune system starts to attack the
bile ducts , causing a autoimmune diseases. More common in people
who are alcoholics.
Diagnosis : When symptoms of primary biliary
cirrhosis are presented to a doctor, the first step in diagnosis is
often a blood test for a substance called AMA (Anti-mitochondrial
Antibody). This antibody is a substance produced by the
disease-fighting system of the body and around 95% of those with PBC
will test positive for this antibody.
In the early stages of PBC the liver is smooth and enlarged. As the
condition progresses, nodules (bumps) appear and the liver becomes
stained with bile.
Blood tests to check liver function, and a liver biopsy (a test on a
tiny sample of tissue), help to determine levels of waste substances
such as copper, or bodily substances such as bilirubin. If levels
were particularly high, it would point to the condition.
X-rays and ultrasound scans can also be used to determine the size
of the liver and rule out other causes
Treatment: There is no complete cure for primary biliary
cirrhosis but the following therapies can have some effect in
managing the condition:
Ursodeoxycholic acid has been shown to have some effect in improving
the passage of bile throughout the liver, and seems to have few side
effects. Immunosuppressive therapy involves using drugs such as
Cyclosporine that interfere with immune reactions in the body. Liver
transplantation may be considered in response to liver failure, or
if the patient has uncontrollable pruritus or severe osteoporosis.
Symptoms can be alleviated through various types of therapies:
Corticosteroids are drugs that may alleviate symptoms but there is a
risk of osteoporosis developing if they are used long term.
Antihistamines are sometimes used but mainly for sedative effect.
Pruritus can be treated with drugs such as cholestyramine or
therapies including ultraviolet light exposure. Treatment of sicca
syndrome (dryness of eyes or mouth) can be carried out using
substances such as artificial tears, lubricating jelly and oestrogen
creams, depending on the symptoms. Other useful measures include:
Vitamin replacement;Checking thyroid activity;Weight-bearing
exercise and calcium supplements to reduce likelihood of
osteoporosis.
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