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Primary biliary cholangitis (PBC)

Small bile duct damage

PBC destroys the small bile ducts which link the liver to the gut — the build-up of bile in the liver leads to cirrhosis

About PBC

In primary biliary cholangitis, the body's defence system attacks the ducts that pass out of your liver. It's not clear why this happens, but it causes the ducts to become inflamed and blocked. In turn, bile, the liquid used to help digest fats and remove waste products from your body, builds up in the liver. This can lead to permanent liver damage.

Need to know

  • What are the symptoms of primary biliary cholangitis? icon plus

    Some people with PBC will never get any symptoms of the disease. Clear symptoms of PBC are constant fatigue or tiredness (in some this can be severe) and intense itching in any part of the body. Other symptoms include:

    • bone and joint ache
    • dry eyes and mouth
    • indigestion, nausea or poor appetite
    • diarrhoea
    • dark urine and pale stools
    • arthritis (inflammation of the joints)
    • mottled palms with red or pink blotches
    • pain or discomfort in the upper right side, below the ribs
    • dizziness when standing up (postural or orthostatic hypotension)
    • jaundice

    Symptoms range from mild to severe but this isn’t always related to the degree of liver damage you have.

  • Diagnosing PBC icon plus

    PBC is usually diagnosed through blood tests. However, many people are only diagnosed with the disease after having a routine blood test for another reason. Most people with PBC have a high level of certain liver enzymes in the bloodstream, and an antibody called type 2 antimitochondrial antibody.

    Once diagnosed, you'll have an ultrasound scan in order to rule out other problems with your bile ducts, and to assess the condition of your liver.

    Transient elastography (FibroScan) to measure scarring levels.

    A liver biopsy may also be recommended to assess your liver and help your consultant decide on the best treatment. A biopsy involves removing a small sample of your liver tissue to be studied for signs of disease.
  • Potential treatment options icon plus

    As PBC is a progressive disease, liver damage gets steadily worse over time. Without treatment, liver failure may occur, which can be fatal. There are a number of treatments for managing symptoms of PBC:

    • Cholestyramine may be prescribed by your consultant to help ease itching.
    • Lozenges, artificial tears and lubricating gels may help dry mouth and eyes.

    To slow down disease progression, a medication called ursodeoxycholic acid (URSO, also referred to as UDCA) has been shown to be effective in protecting the liver from the harmful chemicals in the accumulated bile. In people not responding to ursodeoxycholic acid, other medications called fibrates and obeticholic acid are used.

    A liver transplant is only recommended if other treatments are no longer helpful.


Our HPB consultants

Our medical and surgical consultants specialise in the hepatobiliary system which includes the liver, bile duct and pancreas. 

Consultant with patient

Our locations

From complex HPB surgery to diagnostic tests and procedures, we provide exceptional hepatobiliary care across our network of hospitals, outpatient centres and specialist clinics.

  • The Wellington North Building - Liver Unit

    The Wellington Hospital Liver Unit

    The Wellington Hospital Liver Unit

    North Building, Circus Road, St John's Wood

    London NW8 6DP

    Call 020 7483 5933

  • The Princess Grace Hospital

    42-52 Nottingham Place

    London W1U 5NY

    Appointments 020 7908 8001
    General enquiries 020 7486 1234

  • The HSC exterior

    The Harley Street Clinic

    35 Weymouth Street

    London  W1G 8BJ

    Appointments 020 7935 7700
    General enquiries 020 7034 8181

  • London Bridge Hospital

    London Bridge Hospital

    27 Tooley Street


    SE1 2PR

    Appointments & Enquiries 020 7234 2009
    Imaging Appointments 020 7234 2773

  • The Lister Hospital

    Chelsea Bridge Road


    SW1W 8RH

    Appointments 020 7730 8298
    General enquiries 020 7730 7733

  • The Portland Hospital

    205 - 209 Great Portland Street


    W1W 5AH

    Children's enquiries 020 7390 8020
    Maternity enquiries 020 7390 6068
    Gynaecology enquiries 020 7390 6200

  • HCA UK at The Wilmslow Hospital

    52-54 Alderley Road


    SK9 1NY

    Appointments 020 7483 5148
    General enquiries 01615 160 961

  • MRI scans

    London Liver Centre

    4th Floor, Emblem House

    27 Tooley Street

    London SE1 2PR

    Appointments & enquiries 020 7234 2730

Request an appointment

We're happy to help you make an appointment with one of our experienced consultants.

020 7079 4344
This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
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