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Primary Biliary Cholangitis (PBC)

Contact the UPMC Center for Liver Diseases

To make an appointment with a hepatologist at the UPMC Center for Liver Diseases, call 412-647-1170 or fill out our contact form.


What Is Primary Biliary Cholangitis (PBC)?

Your liver helps your body digest food and removes toxins from your blood. Bile, a fluid that your liver makes, helps with these actions.

Bile moves into your body through small bile ducts inside your liver known as the intrahepatic bile ducts.

PBC is a disease that destroys these bile ducts over time. When bile can no longer move through the ducts, liver damage occurs.

PBC is not a very common disease.

It affects about:

  • 65 out of 100,000 U.S. women.
  • 12 out of 100,000 U.S. men.

Primary biliary cholangitis causes

It's not clear why some people get PBC. Doctors think it's an autoimmune disease in which the body's own immune system attacks the liver.

Researchers don't think parents pass PBC to their children through gene changes, but it sometimes occurs in several family members.

PBC risk factors and complications

PBC is more common in women than men, especially women over the age of 40.

If you have PBC, you're at higher risk for other health issues like:

  • Osteoporosis, or thinning bones.
  • High cholesterol, a fatty substance in the blood that causes harmful plaque to form in the arteries.
  • Cirrhosis and complications.
  • Liver failure, or end-stage liver disease.

Why choose the UPMC Center for Liver Diseases for primary biliary cholangitis care?

Our liver experts:

  • Develop advanced therapies for people with PBC.
  • Care for all types of liver conditions with treatment options tailored to you.
  • Work closely with the UPMC Liver Transplant Program, a national leader in living-donor liver transplants.

Primary Biliary Cholangitis (PBC) Symptoms and Diagnosis

If you have PBC, you might not know it. Some people have no symptoms at all.

As liver damage worsens over time, you might notice symptoms such as:

  • Dark-colored urine.
  • Fatigue, or feeling extremely tired.
  • Itchy skin.
  • Jaundice, or a yellow color in your eyes and skin.
  • Lack of appetite or weight loss.
  • Pain or swelling in your belly.
  • Small yellow bumps on your skin.

Diagnosing PBC

Doctors might find out you have PBC during a blood test for another condition.

If they suspect you have PBC, they may test your blood for anti-mitochondrial antibodies. People with PBC have these antibodies in their blood.

Your doctor will do an exam and ask if anyone else in your family has PBC.

In some cases, they will remove a small sample of liver tissue and study it under a microscope. This is known as liver biopsy.

Learn more about how we find liver disease and the diagnostic testing we do at the Center for Liver Diseases.

Primary Biliary Cholangitis (PBC) Treatment

Doctors can't cure PBC. But they can treat you to help stop — or slow — further liver damage.

The goal of treating PBC is to prevent liver damage. You'll see your doctor for routine physical exams and blood tests to check your liver's function.

Lifestyle changes to treat PBC

Healthy habits are especially vital when you have PBC.

Your doctor will suggest that you:

  • Eat high-calcium foods.
  • Exercise.
  • Avoid alcohol.
  • Limit salt.

Medicine to treat primary biliary cholangitis

Your doctor might prescribe certain medications to help slow liver damage from PBC.

These drugs include:

  • Ursodiol — an acid that helps break down cholesterol in the liver.
  • Obeticholic acid — which may help decrease inflammation in the liver.

Some people with PBC don't have enough vitamins A, D, E, and K in their bodies because the liver can't absorb them. You might take supplements to help replace these vitamins.

Surgery to treat PBC

Over time, PBC may damage the liver so much that you experience liver failure or end-stage liver disease.

Transplant surgery, in which doctors replace a diseased liver with a donated healthy one, is the only treatment for liver failure.

Learn more about liver transplants and living-donor transplants at UPMC.