The liver—the second largest organ in your body—performs many jobs. It processes what you eat and drink into energy and nutrients your body can use, plus it removes harmful substances from your blood. Read up on how to keep your liver healthy and how to live well with various liver diseases.

5 Steps to Take Charge of Your Liver Health

  • Posted on: 14 December 2016
  • By: veras
Pull Quote: 
The liver is our largest organ, and yet we often ignore it. These tips can help you take charge of your liver health.
Long Description: 
The liver is our largest organ, and yet we often ignore it. These tips can help you take charge of your liver health.

by Jennifer Pate, MD

Did you know that October is Liver Awareness Month? While many women across the country are setting aside time to focus on their breast health, October also presents a good opportunity to take ownership of your liver health.

Health Centers: 
womenTALK Blog Topics: 

Unexplained Itching and Fatigue? Time to Get Your Liver Checked

  • Posted on: 23 March 2016
  • By: Guest (not verified)
Long Description: 
Imagine having itchy skin and fatigue with no explanation or diagnosis for your symptoms.

Imagine having itchy skin and fatigue with no explanation or diagnosis for your symptoms. This is what happened to Minnesota native Nishele, 44, who received a primary biliary cholangtis (PBC) diagnosis after years without any answers. Her journey, unfortunately, is like many others who have PBC.

Attachments
womenTALK Blog Topics: 
Health Centers: 

Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis

  • Posted on: 21 March 2016
  • By: jleff
Experts/Authors

Overview What Is It?
NAFLD and NASH:

Section: 

[Section: Diagnosis]

Diagnosis

Nonalcoholic steatohepatitis (NASH) is believed to be one of the most common chronic liver diseases worldwide, affecting an estimated more than 10 percent of the general adult population in the United States.

NASH is usually first suspected in someone whose blood test indicates elevated liver enzymes, such as alanine aminotransferase (ALT) or aspartate aminotransferase (AST). A liver biopsy is required to confirm a NASH diagnosis.

Patients generally feel well in the early stages and only begin to have symptoms—such as fatigue, weight loss and weakness—once the disease is more advanced or cirrhosis develops.

The progression of NASH can take years, even decades. The process can stop and, in some cases, reverse on its own without specific therapy. NASH can also slowly worsen, causing scarring or "fibrosis" of the liver tissue. As fibrosis worsens, cirrhosis develops; the liver becomes seriously scarred, hardened and unable to function normally.

Not everyone with NASH develops cirrhosis, but once serious scarring or cirrhosis occurs, there are no treatments that can reverse the cirrhosis. A person with end stage cirrhosis experiences fluid retention, muscle wasting, confusion (encepalopathy), bleeding from the intestines, jaundice and eventually liver failure. Liver transplantation is the only treatment for advanced cirrhosis with liver failure, and transplantation is increasingly being performed in people with NASH.

No single test can diagnose NASH. Your health care provider will ask you about other health problems you've had. To see if fat is building up in your liver and to rule out other diseases, your health care provider may do tests such as:

This resource was created with the support of Intercept Pharmaceuticals.

[Section: Treatment]

Treatment

Currently, no specific therapies for nonalcoholic steatohepatitis (NASH) exist. The most important recommendations given to people with this disease are to:

  • Reduce their weight (if obese or overweight)
  • Follow a balanced and healthy diet
  • Increase physical activity
  • Avoid alcohol
  • Avoid medications that can harm the liver
  • Get a good control of your diabetes and high cholesterol

Once a person has developed liver failure from NASH, liver transplantation is the only available treatment. In the United States, the proportion of liver transplants attributable to NASH has increased rapidly in past years, and by 2020 the disease is projected to become the leading reason for liver transplant, ahead of chronic hepatitis C and alcoholic liver disease.

This resource was created with the support of Intercept Pharmaceuticals.

[Section: Prevention]

Prevention

Although nonalcoholic steatohepatitis (NASH) has become more common, its underlying cause is still not clear. It most often occurs in people who are middle-aged and overweight or obese. Many people with NASH have elevated blood lipids, such as cholesterol and triglycerides, and many have diabetes or prediabetes, but not every obese person or everyone with diabetes has NASH.

Furthermore, some people with NASH are not obese, do not have diabetes and have normal blood cholesterol and lipids. NASH can occur without any apparent risk factors and can even occur in children. Thus, NASH is not simply obesity that affects the liver.

While the underlying reason for the liver injury that causes NASH is not known, several factors are possible candidates:

  • Insulin resistance
  • Release of toxic inflammatory proteins by fat cells (cytokines)
  • Oxidative stress (deterioration of cells) inside liver cells

NASH ranks as one of the major causes of cirrhosis in America, behind hepatitis C and alcoholic liver disease, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

This resource was created with the support of Intercept Pharmaceuticals.

[Section: Facts to Know]

Facts to Know

  • Nonalcoholic steatohepatitis (NASH) is fat in the liver, with inflammation and damage.
  • NASH occurs in people who drink little or no alcohol, especially people who are middle-aged and overweight or obese.
  • NASH can occur in children.
  • People who have NASH may feel well and may not know they have a liver disease.
  • NASH can lead to cirrhosis, a condition in which the liver is permanently damaged and cannot work properly.
  • Fatigue can occur at any stage of NASH.
  • Weight loss and weakness may begin once the disease advances or cirrhosis occurs.
  • NASH may be suspected if blood tests show high levels of liver enzymes or if scans show fatty liver.
  • NASH is definitively diagnosed by examining a small piece of the liver taken through a needle, a procedure called a biopsy.
  • People who have NASH should reduce their weight, eat a balanced diet, engage in physical activity and avoid alcohol and unnecessary medications.
  • No approved medical therapies for NASH exist at this time.

This resource was created with the support of Intercept Pharmaceuticals.

[Section: Questions to Ask]

Questions to Ask

Having a list of questions to ask a health care provider during an appointment can help you remember your important concerns. Be sure to bring these questions (and any others you may add) and a pen to write down the answers.

1. What is causing fat to build up in my liver?

2. Do I need to lose weight? If so, what percentage of my current body weight do I need to lose?

3. How can I safely lose weight?

4. What diet changes do I need to make if any?

5. Should I change my current physical activity level because of my condition?

6. What lifestyle changes do I need to make, if any?

7. Is it possible to reverse nonalcoholic steatohepatitis (NASH) in my case?

8. What can I do to slow down the progression of NASH?

9. What are symptoms to pay attention to and look out for?

10. How can I manage the symptoms?

11. Will there be pain? Can it be controlled?

12. What symptoms may occur that could require immediate attention?

13. What medications or other substances should I avoid?

14. How will you assess whether the NASH management or treatment is working for me?

15. How often should I see my primary care physician or a liver specialist?

This resource was created with the support of Intercept Pharmaceuticals.

[Section: Key Q&A]

Key Q&A

Q: What is nonalcoholic steatohepatitis (NASH)?
A: The more severe form of nonalcoholic fatty liver disease (NAFLD) is called nonalcoholic steatohepatitis (NASH). NASH causes the liver to swell and may lead to liver scarring. NASH tends to develop in people who are overweight or obese, or have diabetes, high cholesterol or high triglycerides. However, some people have NASH even if they do not have any risk factors. Most people with NASH are between 40 and 60 years old. NASH is more common in women than in men. NASH often has no symptoms, and people can have NASH for years before symptoms occur. NASH is one of the leading causes of cirrhosis in adults in the United States. Up to 25 percent of adults with NASH may develop cirrhosis, according to the American Liver Foundation.

Q: How is NASH diagnosed?
A: NASH is usually first suspected in a person who is found to elevated liver enzymes in tests that are included in routine blood test panels, such as alanine aminotransferase (ALT) or aspartate aminotransferase (AST). A liver biopsy is required to confirm a NASH diagnosis.

Q: It is possible for people with NASH to live healthy, active lives?
A: You can take steps to keep yourself healthy. Talk to your health care provider about treatment options and diet recommendations.

Q: Is NASH contagious?
A: No, NASH is not contagious and cannot be spread from one person to another.

Q: Can people with NASH continue to work and do everyday activities?
A: Yes, people with NASH can continue to work and do everyday activities.

Q: What are the possible complications of NASH?
A: NASH causes the liver to swell and a swollen liver may cause scarring (cirrhosis) over time and may even lead to liver cancer or liver failure.

Q: What can family members of a person with NASH do to reduce their risk?
A: Family members can take the following steps to reduce their risk of NASH:

  • Maintain a healthy weight
  • Eat a healthy diet
  • Exercise regularly
  • Limit alcohol intake
  • Only take medicines that they need and follow dosing recommendations

This resource was created with the support of Intercept Pharmaceuticals.

[Section: Support Groups and Organizations]

Support Groups and Organizations

American Association for the Study of Liver Diseases (AASLD)

American Liver Foundation (ALF)

Fatty Liver Clinic at California Pacific Medical Center (CPMC), San Francisco, CA

Fatty Liver Clinic at CPMC (Facebook site)

This resource was created with the support of Intercept Pharmaceuticals.

Images: 
References: 

Chalasani, et al. AASLD Practice Guidelines. Hepatology. 2012;55(6):2005-2023.

Charlton MR, Burns JM, Pedersen RA, Watt KD, Heimbach JK, Dierkhising RA. Frequency and outcomes of liver transplantation for nonalcoholic steatohepatitis in the United States. Gastroenterology. 2011;141(4):1249-1253.

Kneeman JM, Misdraji J, Corey KE. Secondary causes of nonalcoholic fatty liver disease. Therapeutic Advances in Gastroenterology. 2012;5(3):199-207.

Nonalcoholic steatohepatitis: Diagnosis. The National Institute of Diabetes and Digestive and Kidney Diseases. Updated May 2014. http://www.niddk.nih.gov/health-information/health-topics/liver-disease/nonalcoholic-steatohepatitis/Pages/facts.aspx. Accessed March 9, 2016.

NAFLD, Non-Alcoholic Fatty Liver Disease. American Liver Foundation. Updated January 14, 2015. http://www.liverfoundation.org/abouttheliver/info/nafld/. Accessed March 9, 2016.

Newly diagnosed nonalcoholic fatty liver disease. American Liver Foundation. http://www.liverfoundation.org/downloads/alf_download_921.pdf. Accessed March 14, 2016.

Rahman, et al. World J Gastrointest Oncol. 2013;5(9):186-194.

Williams CD, Stengel J, Asike MI, et al. Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study. Gastroenterology. 2011;140(1):124-131.

Wong, et al. Gastroenterology. 2015;148(3):547-555.

Wree, et al. Nat Rev Gastroenterol Hepatol. 2013;10(11):627-636.

Yilmaz Y. Review article: is non-alcoholic fatty liver disease a spectrum, or are steatosis and non-alcoholic steatohepatitis distinct conditions? Aliment Pharmacol Ther. 2012 Nov;36(9):815-823.

Younossi ZM, Stepanova M, Rafiq N, et al. Pathologic criteria for nonalcoholic steatohepatitis: interprotocol agreement and ability to predict liver-related mortality. Hepatology. 2011;53(6):1874-1882.

Health Centers: 
Create Date: 
Thu, 03/03/2016
Last date updated: 
Tue, 2017-08-15
Long Description: 
Nonalcoholic fatty liver disease (NAFLD) is characterized by accumulation of fat in the liver. It can lead to nonalcoholic steatohepatitis (NASH), a severe form of liver disease.

Primary Biliary Cholangitis (PBC)

  • Posted on: 21 March 2016
  • By: jleff
Experts/Authors

Overview What Is It?
PBC is progressive. A progressive disease is one that gets worse over time. PBC is an autoimmune disease. It causes your body to attack itself. When the body attacks its own cells, it causes inflammation and damage. With PBC, your body attacks your own bile ducts in the liver, causing inflammation, scarring and cirrhosis over time.

Section: 

[Section: Diagnosis]

Diagnosis

Primary biliary cholangitis (PBC) may progress slowly, and many people do not have symptoms, particularly in the early stages of the disease. The most common initial symptoms are fatigue and itching of the skin (pruritis). Other symptoms may include:

  • Abdominal pain
  • Darkening of the skin
  • Small yellow or white bumps under the skin or around the eyes
  • Dry mouth and eyes
  • Bone, muscle and joint pain

As the disease progresses, symptoms of cirrhosis can develop including:

  • Yellowing of the skin (jaundice)
  • Swelling of the legs and feet (edema)
  • Enlarged abdomen from fluid accumulation (ascites)
  • Internal bleeding in the upper stomach and esophagus from enlarged veins
  • Thinning bones (osteoporosis), leading to fractures in the late stages of the disease
  • Increased risk for liver cancer (hepatocellular carcinoma)

Because many people with PBC have no symptoms, the disease is often discovered from abnormal results on routine liver blood tests (elevated alkaline phosphatase). Once PBC is suspected, another blood test to check for antimitochondrial antibody (AMA) is done. AMA is a highly PBC-specific autoantibody found in 90 percent to 95 percent of patients with PBC and less than 1 percent of normal people.

Imaging of the abdomen by ultrasound and a liver biopsy, where a sample of liver tissue is removed with a small needle, can help confirm the diagnosis and assess the degree of liver damage.

This resource was created with the support of Intercept Pharmaceuticals.

For more information, visit www.livingwithPBC.com.

[Section: Treatment]

Treatment

There is no cure for primary biliary cholangitis (PBC), however, there are treatment options that can help people manage their disease.

Ursodiol (brand names Actigall, URSO 250, URSO Forte) is a naturally occurring bile acid (ursodeoxycholic acid or UDCA) that helps move bile out of the liver and into the small intestine. Ursodiol is effective in about half of people with PBC.

In 2016, the U.S. Food and Drug Administration approved obeticholic acid (Ocaliva), an FXR agonist that can lower levels of alkaline phosphatase (ALP), a liver enzyme and biomarker used to track progression of PBC. Obeticholic acid may be used in combination with ursodiol for people in whom ursodiol isn't completely effective or as a single therapy in people who cannot tolerate ursodiol. While obeticholic acid is approved, there are still ongoing trials to assess long-term impact on disease progression and symptom management.

If used early enough, these treatments can improve liver function and delay the need for a liver transplant. People with PBC must take medication every day for life. For people with PBC who also have symptoms of autoimmune hepatitis, medications to suppress the immune system may also be prescribed, including azathioprine and prednisone.

Liver transplantation is considered when medical treatment no longer sufficiently controls the disease and a person develops end-stage liver disease as a result.

When people respond well to treatments:

  • Their disease progression slows.
  • Liver transplant may not be necessary.
  • They could live longer than if they had not treated their PBC.

Although these treatments can help people in any stage of PBC, it is important to start treatment as soon as possible because medicines work best in people whose PBC is still in the early stages.

People who don't respond well to treatments are at the highest risk for disease progression.

How do you know if you are responding to treatment?

  • Have your health care provider check your ALP and bilirubin levels every three to six months with a blood test.
  • Record and keep track of your ALP and bilirubin levels.

Treating the Symptoms

Although there is no cure for PBC, your health care provider may recommend treatments for your symptoms, including:

  • Over-the-counter antihistamines like diphenhydramine (Benadryl) may be helpful in treating intense itching, one of the most common symptoms of PBC. A drug called cholestyramine (Questran) helps bind bile and decreases the itching associated with elevated bilirubin levels. Other agents such as rifampicin, naltrexone and sertraline may be prescribed.
  • Eye drops or artificial tears can relieve dry eyes.
  • Sucking on hard candy or chewing gum increases saliva, which helps relieve dry mouth. Saliva substitutes and some medications also can be used.

Preventing Complications

Your health care provider may conduct these tests to help you avoid complications:

  • Blood tests may be used to monitor for deficiencies in fat-soluble vitamins.
  • As PBC progresses, some people need to replace the fat-soluble vitamins lost in fatty stools, so you may be put on vitamin A, D, E and K replacement therapy.
  • Because people with PBC are at a higher risk for osteoporosis, calcium and vitamin D are usually prescribed. Screening for osteoporosis with bone-density testing may be recommended.
  • As liver function decreases over time, complications associated with cirrhosis will need to be addressed and treated. Once cirrhosis has developed, screening for internal bleeding and liver cancer is often recommended.

Lifestyle Changes

Maintaining a healthy lifestyle can help people with PBC feel better, as well as relieve or prevent some symptoms associated with the disease. Once you are diagnosed, your health care provider may suggest the following:

  • Start a reduced-sodium and/or low-fat diet.
  • Avoid or lower alcohol consumption.
  • Lower caffeine intake.
  • Avoid stress when possible.
  • Start exercising, particularly walking.
  • Stop smoking.
  • Maintain good skin care.
  • Get regular dental examinations.

Keep in mind that PBC usually advances slowly over a period of years. Many people lead normal lives for years without symptoms, depending on how early the diagnosis is made. And while there is no cure, people are having good results slowing disease progression and living longer without complications by adhering to their medication regimen and maintaining a healthy lifestyle.

This resource was created with the support of Intercept Pharmaceuticals.

For more information, visit www.livingwithPBC.com.

[Section: Prevention]

Prevention

The exact cause of primary biliary cholangitis (PBC) is unknown. However, it is known that PBC is not caused by alcohol or illegal-drug use. It is an autoimmune disease that occurs in genetically susceptible individuals. The body's immune system mistakenly attacks and destroys its own cells—in this case, the cells of the intrahepatic bile ducts. Some people diagnosed with PBC may also have one or more other autoimmune diseases.

Women are nine times more likely than men to develop PBC, meaning that women make up about 90 percent of PBC cases.

The disease most often develops during middle age and is usually diagnosed in people between the ages of 35 and 60 years. PBC is more common among siblings and in families where one member has been affected, indicating a gene may be involved.

This resource was created with the support of Intercept Pharmaceuticals.

For more information, visit www.livingwithPBC.com.

[Section: Facts to Know]

Facts to Know

  1. Primary biliary cholangitis (PBC) is not caused by alcohol or drug use.
  2. PBC is an autoimmune disease that cannot be prevented or cured, but there is treatment available to slow disease progression.
  3. Many people with PBC live normal, healthy lives with proper treatment.
  4. An estimated 90 percent of patients with PBC are women.
  5. Since 1988, PBC has been the second overall most common reason for liver transplant among U.S. women.

This resource was created with the support of Intercept Pharmaceuticals.

For more information, visit www.livingwithPBC.com.

[Section: Questions to Ask]

Questions to Ask

Having a list of questions to ask your health care provider during an appointment can help you remember your important concerns related to primary biliary cholangitis (PBC). In addition to getting your liver enzymes (alkaline phosphatase and bilirubin) checked every three to six months and doing what you can to keep your enzymes as close to normal as possible, bring these questions (and any others you may add) and a pen to write down the answers.

1. What are the results of my blood tests or other medical tests? Please explain the results.

2. What are the results of my biopsy? Please explain the results.

3. Do you suggest any change in my medications, treatments or testing?

4. Would you recommend any lifestyle changes for me, such as changes in diet, exercise or job-related activities?

5. Would you be willing to refer me for:

  • a second opinion;
  • further medical testing;
  • dietary guidance;
  • physical therapy; or
  • any other outside assistance?

6. Will you send copies of my medical records to my other health care providers?

7. Will you give me copies of my lab results and medical tests?

8. How many patients with PBC do you treat?

9. What are your thoughts on alternative medical therapies?

10. What symptoms or associated diseases might I expect from my liver disease as it progresses?

11. Will you support me when the time is appropriate to file for medical disability?

12. Is your office staff prepared to assist me if I need to sign up to get a liver transplant?

13. Are you willing to refer me for participation in research studies for PBC or associated diseases?

Questions the caregiver or support person may want to ask the doctor:

1. What can I do to help?

2. What type of daily assistance will I need to provide?

3. How can I help with treatments, emotions, physical changes or pain, financial support or other issues?

4. What changes might I expect to see physically or mentally?

5. Would you recommend counseling for the person I'm caring for or for the family or me?

6. Is it necessary to apply for medical disability at this time?

7. What other assistance may I offer?

This resource was created with the support of Intercept Pharmaceuticals.

For more information, visit www.livingwithPBC.com.

[Section: Key Q&A]

Key Q&A

Q: What is primary biliary cholangitis (PBC)?
A: PBC is a long-term autoimmune disease that affects the liver. In simple terms, the body thinks the liver is a foreign object and tries to use immunological defense mechanisms against the bile ducts, which leads to toxic bile build-up. It is not related to alcohol or drugs and, at the moment, is incurable. However, there is treatment to slow the progress of the condition.

Q: Why do I have it?
A: It is important to know that you don't catch PBC. For PBC to develop, two things have to happen. The first thing is that you have a genetic predisposition. Approximately 25 areas within your DNA have been linked to PBC: some are linked to autoimmune disorders generally, and some are PBC specific. Assuming that you have this genetic predisposition, you then have to encounter a trigger. Triggers vary from person to person and could be viral, bacterial, chemical or even a traumatic experience.

Q: Can I pass it on?
A: PBC cannot be passed on like a cold or the flu. It is possible that you could pass on the genetic predisposition to your children, but not PBC itself. If you look at your family tree, you will often encounter other autoimmune conditions such as rheumatoid arthritis, lupus, type 1 diabetes, hypothyroidism, celiac disease, scleroderma and Sjögren's, to name a few. There is less than a 5 percent chance that your children would develop PBC.

Q: What is my life expectancy with PBC?
You are more likely to die "with" PBC than "from" PBC. PBC is generally a long-term condition, although there are occasional cases where the PBC progresses more quickly. However, this still tends to be in years rather than weeks or months.

Q: What can I do to manage my disease?
A: Use resources to track your symptoms. Collecting information about your symptom experience can be helpful to your doctors as they help you manage your PBC. Monitor your itchiness, fatigue and other PBC symptoms. Manage the symptoms of your disease so you can stay on track with the medicine that helps your liver fight PBC.

This resource was created with the support of Intercept Pharmaceuticals.

For more information, visit www.livingwithPBC.com.

[Section: Support Groups and Organizations]

Support Groups and Organizations

livingwithPBC.com
You can take action. You are not alone. Connect with PBC communities to help you manage your disease. Learn about getting support from the PBC community.

There are groups and organizations dedicated to supporting people with PBC all over the world. Follow the links below to find out more about each group.

PBCers Organization
The mission of this U.S.-based organization is to unite people diagnosed with primary biliary cholangitis (formerly known as primary biliary cirrhosis), which is a progressive chronic liver disease. The organization helps PBC patients and their caregivers, friends and families cope with PBC and improve the quality of their lives through education and support.
Address: PBCers Organization, 1430 Garden Road, Pearland, TX 77581
Email: [email protected]
Website: PBCers.org  

PBC Society
A Canadian organization with regional groups that provide support and encouragement, education and information, and fundraising for research on PBC
Address: Canadian PBC Society, 4936 Yonge Street, Suite 221, Toronto, Ontario M2N6S3
Email: [email protected]
Website: PBC-Society.ca

PBC Foundation
A UK-based patient organization with nearly 10,000 members that provides support to people around the world who are living with PBC, as well as their families and friends
Address: The PBC Foundation, 2 York Place, Edinburgh EH1 3EP
Email: [email protected]
Website: PBCFoundation.org.uk

Visit the following websites for more information about PBC:

American Liver Foundation
A national organization for patients, families, and professionals that is dedicated to the prevention, treatment, and cure of liver diseases such as PBC
Address: American Liver Foundation, 39 Broadway, Suite 2700, New York, NY 10006
Website: LiverFoundation.org

Mayo Clinic
A nonprofit medical practice and research group that provides information about a variety of medical conditions, including PBC
Website: MayoClinic.org

Medline Plus
A website that provides health information for people with PBC and other diseases as a service of the US National Library of Medicine
Address: US National Library of Medicine, 8600 Rockville Pike, Bethesda, MD 20894
Website: MedlinePlus.gov

Medicine Net
A website written by doctors with some information aimed at people with PBC and their caregivers; includes comments from people with PBC
Website: MedicineNet.com

National Organization for Rare Disorders (NORD)
An organization that provides services, such as advocacy and education, to help improve the lives of people with rare diseases
Address: National Organization for Rare Disorders, 55 Kenosia Avenue, Danbury, CT 06610
Website: RareDiseases.org

National Digestive Diseases Information Clearinghouse
A website that provides information on digestive diseases, including studies recruiting people with liver disease, provided by the National Institute of Diabetes and Digestive and Kidney Diseases
Address: National Digestive Diseases Information Clearinghouse, 2 Information Way, Bethesda, MD 20892
Website: NIH.gov

The University of Chicago Medicine Liver Disease Patient Resources
An online library containing information about the liver and liver disease, including information for people with PBC
Address: University of Chicago Medicine, 5841 S. Maryland Avenue, Chicago, IL 60637
Website: UCHospitals.edu

This resource was created with the support of Intercept Pharmaceuticals.

For more information, visit www.livingwithPBC.com.

References: 

Hirschfield GM. Diagnosis of primary biliary cirrhosis. Best Pract Res Clin Gastroenterol. 2011;25(6):701-712.

Primary biliary cholangitis. BMJ Best Practice. 2017 Jan. http://us.bestpractice.bmj.com/best-practice/monograph/344.html. Last accessed 5 Jun 2017. 

Myers, et al. Hepatology. 2009;50(6):1884-1992. doi: 10.1002/hep.23210.

Lasker JN, Sogolow EDShort LMSass DA. The impact of biopsychosocial factors on quality of life: women with primary biliary cirrhosis on waiting list and post liver transplantation. Br J Health Psychol. 2011;16(3):502-527.

Lindor, et al. AASLD practice guidelines. Hepatology. 2009;50(1):298-300.

Gershwin ME, Mackay IR, Sturgess A, Coppel RL. Identification and specificity of a cDNA encoding the 70 kd mitochondrial antigen recognized in primary biliary cirrhosis. J Immunol. 1987;138:3525-3531.

Parikh-Patel, et al. Hepatology. 2001;33(1):16-21.

Primary biliary cirrhosis. American Liver Foundation. 2015. http://www.liverfoundation.org/downloads/alf_download_1195.pdf. Accessed March 15, 2016.

Create Date: 
Mon, 03/21/2016
Health Centers: 
Last date updated: 
Tue, 2017-08-15
Long Description: 
Primary biliary cholangitis, or PBC, is a progressive autoimmune disease that damages or destroys the bile ducts in the liver. It can cause inflammation, scarring and cirrhosis.

About the Liver

  • Posted on: 21 March 2016
  • By: jleff
Short Description: 
The liver performs many important jobs in your body, so it's important to know how to take care of your liver.
Long Description: 
The liver performs many important jobs in your body, so it's important to know how to take care of your liver.

liver

By: Kidist Yimam, MD
Director, Autoimmune Liver Disease Program
California Pacific Medical Center
San Francisco, CA

Why is the liver important?

The liver is the second largest organ in your body, weighing about three pounds. It is located under the right rib cage and is shaped like a football flattened on one side.

Health Centers: 

Pages