Her Life Depends on a New Liver.

To help the FabOverFifty community understand PBC and what liver screening can tell us, we spoke to Dr. Nancy S. Reau, a hepatologist at the Rush University Medical Center in Chicago.

How many women get PBC?

Although PBC is rare, it affects approximately one in 1,000 women over the age of 40.

What causes PBC?

Researchers think it’s triggered by a combination of genetic and environmental factors.

What are the symptoms of PBC?

The majority of patients with PBC do not experience any symptoms.  Symptoms for some patients may include fatigue and itching. Jaundice (yellowing of the skin and/or eyes) may occur in severe cases.

What are the blood screening tests for liver function?

A comprehensive metabolic panel (CMP) often includes a liver panel to measure enzymes, proteins, and substances that are produced, processed or eliminated by the liver and are affected by liver injury. Some show damaged liver cells and reflect a decrease in the liver’s ability to perform one or more of its functions. These tests give a healthcare practitioner a snapshot of the health of a person’s liver, an indication of the potential severity of any liver injury, change in liver status over time, and a starting place for further diagnostic testing, according to the website labtestsonline.org.

Routine liver blood tests measure the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP). Elevated levels should be assessed for underlying liver disease. If your numbers don’t come back to normal, then be sure to discuss with your healthcare provider or see a liver specialist like a hepatologist.

Once PBC is diagnosed, how long can a patient expect to live?

A patient who is diagnosed early and responds well to medication can have a normal life span. When medications are effective, PBC shouldn’t limit a patient’s ability to have a high-quality life. A patient can even live to be 80 or 90 years old. With early diagnosis, and with no pre-existing cirrhosis, you can do well on treatment.

If PBC has progressed, and you’re experiencing itching and fatigue, does that mean your liver is scarred?

Your liver life depends on the amount of scar tissue you have, but fatigue and itching aren’t linked to the degree of scar tissue.  Not everyone with PBC has cirrhosis (a great deal of scarring that would necessitate a liver transplant). If left untreated, PBC can progress to hepatic fibrosis (liver scarring), cirrhosis, liver failure, and death unless a patient receives a liver transplant.

People often associate alcohol with cirrhosis, but alcohol isn’t the only cause. PBC is unrelated to alcoholism, a misconception that can create an unnecessary stigma for patients who suffer from the disease.

What else would you tell a woman with PBC?  

You’re at a higher risk for osteoporosis because PBC often causes Vitamin D deficiency. Also make sure to talk to your children if you’re diagnosed because PBC can be inherited. Early detection through routine liver blood screenings, including an Alkaline Phosphatase (ALP) test, is very important.   

This blog post was written by FabOverFifty thanks to a sponsorship by Intercept Pharmaceuticals.

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