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Primary Biliary Cirrhosis

  • Cynthia M. Johnson, MA
Publication Type:


Primary Biliary Cirrhosis



Primary biliary cirrhosis (PBC) is a liver disease that results in swelling of the bile ducts. Bile is a fluid made by the liver that helps break down food in the intestines. It is carried from the liver to the gallbladder and small intestine through bile ducts.

PBC makes it hard for bile to move out of the liver because it cannot pass through the ducts. This causes it to backup and leads to liver damage.


The exact cause of PBC is not known. It appears to be a problem with the immune system attacking health tissue. Genes and the environment may play a role.

Risk Factors

PBC is more common in women. Other things that may play a role are:

  • A family history of PBC
  • Viral hepatitis—both hepatitis B and C


Symptoms of PBC include:

  • Tiredness
  • Itchy skin
  • Yellowing of the skin and eyes
  • Yellow or white bumps around the eyelids
  • Damaged blood vessels just below the surface of the skin
  • Belly pain, especially in upper right side


The doctor will ask about symptoms and past health. A physical exam will be done.

Blood tests will be done to check liver function.

A sample of the liver may be taken to look for damage. This can be done with a biopsy.

Pictures of the bile ducts may be taken. This can be done with:

Liver Biopsy.

Nucleus Imagehttp://services.epnet.com/getimage.aspx?imageiid=24882488si55551313.jpgPlacement of Liver Biopsy NeedleNULLjpgPlacement of Liver Biopsy NeedleNULL\\filer01\Intellect\images\si55551313.jpgCopyright © 2002 Nucleus Communications, Inc. All rights reserved.16NULL2002-10-012553912488_99913Copyright © Nucleus Medical Media, Inc.


The goal of treatment is to manage symptoms, slow liver damage, and lower the risk of other problems. Options are:


There are no current guidelines to prevent PBC.





  • Hirschfield GM, Dyson JK, Alexander GJM, et al. The British Society of Gastroenterology/UK-PBC primary biliary cholangitis treatment and management guidelines. Gut. 2018 Sep;67(9):1568-1594.
  • Lindor KD, Bowlus CL, Boyer J, Levy C, Mayo M. Primary Biliary Cholangitis: 2018 Practice Guidance from the American Association for the Study of Liver Diseases. Hepatology. 2019 Jan;69(1):394-419.
  • Primary biliary cholangitis (PBC). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/primary-biliary-cholangitis-pbc.
  • Primary biliary cirrhosis. American Liver Foundation website. Available at: https://www.liverfoundation.org/for-patients/about-the-liver/diseases-of-the-liver/primary-biliary-cholangitis.
  • Primary biliary cirrhosis. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/liver-disease/primary-biliary-cholangitis.
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.