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Primary biliary cholangitis

Cholangitis biliaris primaria · Primární biliární cholangitida

What it is

The immune system destroys the small bile ducts inside the liver, slowly scarring it; nine in ten patients are women.

Symptoms & signs

  • Tiredness
  • itching, often severe
  • dry eyes and mouth
  • pain under the right ribs
  • yellow skin in late disease
  • fatty deposits around the eyes

🚩 Get help if…

  • call 112 / 911 now Vomiting blood or black, tarry stools
  • call 112 / 911 now Confusion or unusual drowsiness
  • see a doctor soon Yellow skin or eyes
  • see a doctor soon Swelling of the belly or legs

Where it strikes

Medical treatment

  • Ursodeoxycholic acid for life
  • elafibranor or seladelpar if UDCA is not enough
  • cholestyramine or rifampicin for itch
  • bone density care
  • liver transplant in end stage

Natural & lifestyle

  • Avoid alcohol
  • calcium and vitamin D for the bones
  • cool showers and emollients for itch

Emerging & experimental

  • Linerixibat and other IBAT inhibitors for itch
  • setanaxib
  • stem-cell therapy

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Milk thistle (silymarin) — liver trials disagree; little studied in PBC mixed evidence
  • Bezafibrate — the BEZURSO trial improved blood tests and itch; off-label in many countries trials support
  • Liver 'detox' and flushes — anecdotal; some herbs injure the liver anecdotal / traditional

ICD codes