Monday, August 11, 2014

Symptoms of PBC

According to the American Liver Foundation, individuals with primary biliary cirrhosis (PBC) may not have any symptoms in the earliest stages of the disease. The most common symptoms include pruritus and fatigue. Pruritus is extreme itchiness occurring in various parts of the body, including the back and upper and lower limbs. The degree of fatigue a person with PBC experiences varies, from day to day and from one individual to the next, with some sufferers experiencing extreme, chronic fatigue.

As the disease progresses, a person with primary biliary cirrhosis might experience edema (fluid retention) in the abdomen and ankles, skin darkening, and fatty deposits on the skin near and around the eyes. When the disease enters into the later stages, an individual can develop jaundice. Symptoms also include diarrhea and weight loss. Some symptoms occurring in the end stages of the disease include ascites, encephalopathy, and varices bleeding.

Ascites is a word used to describe the fluid build up that occurs within the peritoneal cavity. The peritoneal cavity is a space located between to membranes in the abdomen (the parietal peritoneum and visceral peritoneum) that separate the abdominal wall from the abdominal cavity. Hepatic encephalopathy is a result of liver failure and its occurrence includes a changed level of consciousness, confusion, and coma. Xanthelasma, the appearance of fatty deposits under the skin in and around the eyes, is another symptom of the disease.

Primary biliary cirrhosis often runs hand in hand with other diseases, especially those that are autoimmune in origin. The occurrence of other diseases along with PBC is called comorbidity. People with PBC might develop gallstones, renal stones, Osteoporosis, and malabsorption, as well as other digestive issues. Additional complications that can result from PBC include anemia (low iron levels in the blood), splenomegaly (spleen enlargement), cholesterol elevation, and vitamin deficiencies. This disease sometimes appears with Sjögren's syndrome, another autoimmune disease, that causes a person's white blood cells to attack and destroy two different exocrine glands: the lacrimal glands that produce tears and salivary glands that produce saliva. Thus, the primary symptoms of Sjögren's syndrome include xerostomia (dry mouth), and keratoconjuctivitis sicca (dry eyes). PBC sufferers can also develop rheumatoid arthritis.  A person with PBC might also develop portal hypertension in the portal vein system, including the vein and its tributaries and branches. The portal vein (sometimes called the hepatic portal vein), is a blood vessel that carries blood from the spleen and gastrointestinal tract to a person's liver. Cirrhosis, the end product of primary biliary cirrhosis, can cause portal hypertension and the latter can lead to esophageal varices (sometimes called oesophageal varices). Esophageal varices appear in the lower portion of the esophagus and can result in bleeding caused by the dilation of submucosal veins.

Symptoms Recap 

  • Edema (Fluid Retention)
  • Fatigue (Potentially Chronic)
  • Jaundice
  • Pruritus (itchiness)
  • Skin darkening

 Comorbidity and Complications

  • Anemia
  • Ascites
  • Arthritis
  • Cholesterol elevation
  • Digestive issues
  • Esophageal varices bleeding
  • Gallstones
  • Hepatic encephalopathy
  • Keratoconjuctivitis sicca (dry eyes)
  • Malabsorption
  • Osteoporosis
  • Portal hypertension
  • Renal stones
  • Rhuematoid arthritis
  • Sjögren's syndrome or sicce syndrome (dry eyes and mouth)
  • Splenomegaly (Spleen enlargement)
  • Thyroid issues (Hypothyroidism)
  • Vitamin deficiencies (particularly A, D, E, and K).
  • Xanthelasma (Fatty deposits on the skin around the eyes)
  • Xerostomia (dry mouth)

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