Primary Biliary Cholangitis (PBC)
Primary biliary cholangitis (PBC), previously known as primary biliary cirrhosis, is an inflammatory condition of the bile ducts resulting in narrowing and distortion of the bile ducts; this can eventually cause damage to the surrounding liver cells. The disease more commonly affects middle-aged women. The onset of symptoms is gradual, most commonly with fatigue and itching skin as the first symptoms. If obstruction to the flow of bile occurs, this can lead to liver cholangitis. This disease is an autoimmune disease where the patient’s own immune system attacks their bile ducts.
PBC has many similarities to the autoimmune disease called sclerosing cholangitis; thus, essentially the dietary and supplement program is the same for both diseases. As with sclerosing cholangitis, excellent results and long-term control of this disease can usually be achieved with integrative and nutritional medicine.
What are the symptoms of PBC?
The symptoms may include:
- enlarged liver
- abdominal pain
- fatty deposits under the skin
- soft yellow fatty spots on the eyelids (xanthelasma)
- fatty pale stools
Liver function tests, an ultrasound scan and a fibroscan should be done. Some doctors will want to do a liver biopsy for a definitive diagnosis. Blood tests for mitochondrial antibodies will be positive in about 95% of cases. Blood tests for Vitamin A, Vitamin K, and Vitamin D can be done as without adequate bile flow the absorption of fat soluble vitamins is compromised.
Treatment and general recommendations
- You must avoid ALL gluten. This is essential for all autoimmune diseases and in order to heal leaky gut.
- Avoid ALL margarines and dairy products.
- Avoid deep fried foods and hydrogenated vegetable oils.
- Limit red meat and poultry that is not free range or grass fed. Some people have found that a vegan diet has helped them – but no matter what you choose you must avoid gluten and processed food.
- Avoid alcohol.
- Avoid excess sugar and sugary foods; choose fresh fruit or dried fruits instead.
- Drink 2 liters of water or herbal tea each day. You may drink good quality coffee and black tea but do not add cow’s milk to it.
- Avoid artificial sweeteners (see www.dorway.com).
Follow the principles of eating in the book “Healing Autoimmune Disease”. Make these principles a way of life. Eat plenty of avocados, as these contain high amounts of vitamin E which reduces liver scarring.
Cholestyramine (or colestipol) may reduce the itching; this drug works by reducing blood levels of bile acids and improving the clearance of bile acids in the skin.
Ursodeoxycholilc acid (or actigall) may also improve clearance of bile from the bloodstream.
See your doctor every 3 to 4 months for check up and liver function tests.
Recommended supplements for primary biliary cholangitis
- Livatone Plus Capsules
Take 2 capsules with food twice daily – This will stimulate the phase 1 and 2 detox pathways in the liver, improve liver function and reduce inflammation.
- MSM Plus Vitamin C
Take 1 teaspoon once or twice daily in water or raw vegetable juice – MSM is an organic sulfur food powder. Sulfur may assist in preventing further scar tissue.
- Vitamin D
Take 2000 to 5000 I.U. daily. Vitamin D helps to reduce inflammation.
- N-Acetyl-Cysteine (NAC)
Take one to two capsules twice daily, 15 minutes before food.
The above statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any disease.