PBC: Can There Be Complications?

Medically Reviewed by Jennifer Robinson, MD on December 12, 2019

If primary biliary cholangitis (formerly known as primary biliary cirrhosis) isn't treated, or if it gets worse and causes liver damage, there's a chance you could have other serious problems. That's why your doctor will keep a close eye on you. Some of those issues include:

Portal hypertension:  Your portal vein carries blood from your stomach, intestines, spleen, gallbladder, and pancreas to your liver. Scar tissue from cholangitis blocks normal circulation and can boost pressure in your portal vein. That leads to problems like swelling, an enlarged spleen and blood vessels, and toxin buildup.

Toxin buildup:  When your liver can't remove toxins from your blood, they could build up in your brain. You might notice problems with memory and concentration. It may also cause confusion, sleep problems, and personality shifts. It can become so serious that you wind up in a coma. This condition is called hepatic encephalopathy.

Enlarged veins:  When blood can’t flow freely through your portal vein, it can back up elsewhere, especially your stomach and esophagus. That leads to more pressure in your veins, which can trigger bleeding and enlarged blood vessels, called varices. This is serious, and you'd need to see a doctor right away.

Enlarged spleen:  Portal hypertension can fill your spleen with white blood cells and platelets. That means there are fewer of them elsewhere in your blood where your body needs them.

Swelling: When your liver fails, fluid often builds up in your ankles, feet, legs, and belly. If there’s too much, you could get a serious infection called bacterial peritonitis. You’ll need to treat it right away.

Weak bones:  Your bones could become thin, weak, and easier to break. You could get osteoporosis. Your doctor will prescribe calcium and vitamin D to help keep your bones strong and prevent problems.

Gallstone and bile duct stones: When bile backs up and can't flow through the ducts, it can harden and turn into stones. You could also get stones if bile can't flow easily to and from your gallbladder. They’re often painful and can lead to infections.

Problems with fat absorption: When bile can't move around the way it should, it can be hard for your body to absorb fat. You might not get enough of vitamins A, D, E, and K -- the ones that dissolve in fat. You might also have loose, greasy bowel movements because of fat buildup in your stool. Your doctor might suggest you take these vitamins as replacement therapy.

Liver cancer: The damage that comes with cholangitis could make you more likely to get it. Treatments work best if you find tumors early, so your doctor will check for signs of liver cancer every 6-12 months. They might use blood tests, ultrasound, or both.

Other diseases: You also may be more likely to get conditions related to your immune system, like thyroid problems, limited scleroderma (CREST syndrome), Sjogren’s syndrome, and rheumatoid arthritis.

WebMD Medical Reference



National Institute of Diabetes and Digestive and Kidney Diseases: "Primary Biliary Cirrhosis."

Mayo Clinic: "Primary Biliary Cirrhosis: Complications."

American Liver Foundation: "Primary Biliary Cholangitis (PBC, previously Primary Biliary Cirrhosis)."

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