Primary Biliary Cholangitis: Causes, Symptoms, and Treatment Options

When your body’s immune system attacks the small bile ducts in your liver, you might be dealing with primary biliary cholangitis, a chronic autoimmune liver disease that slowly destroys bile ducts, leading to liver damage and scarring. Also known as PBC, it’s not caused by alcohol or viruses—it’s your own immune system turning against you. This condition mostly affects women over 40, and while it’s rare, it’s one of the most common autoimmune liver diseases out there. Left untreated, PBC can lead to cirrhosis, liver failure, and the need for a transplant.

The liver uses bile to break down fats and remove toxins. In PBC, the bile ducts get inflamed and scarred, so bile backs up in the liver. That buildup causes damage over time. Common signs include extreme fatigue, itchy skin (often worse at night), dry eyes and mouth, and yellowing of the skin or eyes as the disease progresses. Many people don’t feel sick at first—PBC is often found during routine blood tests when liver enzymes like ALP and GGT are high. A positive AMA (anti-mitochondrial antibody) test is a strong clue, and sometimes a liver biopsy confirms it.

There’s no cure, but ursodeoxycholic acid, a bile acid medication that helps move bile out of the liver and reduces damage is the first-line treatment for most patients. If that doesn’t work well enough, obeticholic acid, a newer drug that targets bile flow and inflammation may be added. Lifestyle changes matter too—cutting back on alcohol, avoiding raw shellfish, staying active, and getting enough vitamin D and calcium can slow progression. Regular monitoring by a liver specialist is key.

What you’ll find below are real, practical guides that connect directly to PBC and related liver health topics. From how certain medications affect liver function to how autoimmune conditions interact with other systems in the body, these posts give you the no-fluff facts you need to understand your health better. Whether you’re newly diagnosed, managing symptoms, or supporting someone who is, the information here is grounded in what actually works—not guesswork.