Primary biliary cirrhosis or PBC is a progressive disease of the liver caused by a buildup of bile within the liver (cholestasis) that results in damage to the small bile ducts that drain bile from the liver. Over time, this pressure build-up destroys the bile ducts leading to liver cell damage. As the disease progresses and enough liver cells die, cirrhosis and liver failure occur.

Bile is manufactured in the liver and then transported through the bile ducts to the gallbladder and intestine where it helps digest fats and fat soluble vitamins (A,D,E,K). When bile cannot be drained from the liver, it causes inflammation that leads to cell death. Scar tissue gradually replaces the areas of damaged liver and then the Gallbladder and liver cannot perform necessary functions.

The cause of Primary biliary cirrhosis (PBC) is still unknown. It is most likely an autoimmune disease, where the body’s immune system attacks its own cells (the bile ducts are under attack and are destroyed).

What are the risk factors for primary biliary cirrhosis?

• There may be a genetic component to the development of PBC since a person with the disease is likely to have a family member also afflicted.
• Women are nine times more likely than men to develop Primary biliary cirrhosis (PBC). It most often develops in the middle age (between the ages of 40 to 60).
• The disease is seen more often in white, northern Europeans, compared to African and Caucasians.

Up to a quarter of patients with primary biliary cirrhosis are asymptomatic, meaning they do not have symptoms at the time of diagnosis and the disease is found incidentally because of abnormal liver blood tests.

The most common initial symptoms are fatigue or a sense of being abnormally tired and, skin that itches. Because of the intense itching and scratching, the skin may become darkened and discolored in some areas. The patient may complain of dry mouth and eyes.

Because there may be liver inflammation, some patients may experience right upper quadrant abdominal pain, where the liver is located.

Should the liver damage progress, the symptoms of cirrhosis may develop. These include muscle wasting, ascites (swelling of the abdomen due to fluid accumulation), leg swelling, jaundice (yellow coloration of the skin), and confusion.

The diagnosis of Primary biliary cirrhosis (PBC) is considered when the doctor suspects that there might be liver inflammation based upon the history and physical examination. Initially there may be few symptoms like itching or fatigue to help guide further testing

The diagnosis may be made incidentally when abnormal liver functions be found on routine blood tests drawn for another reason. Liver function tests include AST (aspartate aminotransferase), ALT (alanine aminotransferase), GGT (gamma-glutamyl transpeptidase), alkaline phosphatase and bilirubin. Blood levels tend to become elevated in liver disease and they may rise in specific patterns depending upon the underlying cause of inflammation.

Once the diagnosis is suspected, a blood test to check for antimitochondrial antibody (AMA) is usually done. This is positive in over 90% of patients with PBC.

Other blood tests may be considered including a complete blood count (CBC) and cholesterol levels.

Imaging of the abdomen by ultrasound, CT scan or MRI is often considered to look for structural changes in the liver and to search for tumors.

A liver biopsy may help confirm the diagnosis, liver biopsy also useful to help stage the disease and deciding its severity at the time of diagnosis.

Allopathic Treatment

In allopathy the only “cure” for primary biliary cirrhosis is liver transplant, but it is only considered as a treatment option if other less aggressive treatments have failed and the patient develops liver failure; while Homeopathy has many medicines having good results in primary biliary cirrhosis.

Allopathic drug “Ursodiol (Actigal) or ursodeoxycholic acid (UDCA)” is the first line treatment for primary biliary cirrhosis. It helps the liver transport bile into the gallbladder and intestine, in an attempt to prevent cholestasis.

Depending upon the severity of the disease, immune suppression drugs may be prescribed, including methotrexate (Rheumatrex, Trexall), cyclosporine and prednisone.

Itching may be intense and difficult to control. Antihistamines like diphenhydramine (Benadryl) may be helpful but other drugs may be considered including cholestyramine (Questran, Questran Light), which helps bind bile and decrease the itching associated with elevated bilirubin levels in the blood.

Complications of Primary biliary cirrhosis (PBC) will need to be cared for. These include cirrhosis, portal hypertension, gastrointestinal bleeding, osteoporosis, and vitamin deficiencies.

During and after the allopathic treatment the complications of primary biliary cirrhosis develop as the ability of the liver to function decreases. Cirrhosis describes liver scarring and failure. As we know that the liver is responsible for helping to digest food, producing proteins, blood clotting factors, and enzymes that help digest food.

Some complications include the following:

Ascites: Fluid collection within the abdomen that occurs because the liver cannot produce enough albumin, a protein that helps keep fluid within the blood vessels. Ascites fluid is prone to infection and a condition called spontaneous bacterial peritonitis (peritoneum=sac that contains the abdominal organs + itis=inflammation)

Edema: Swelling of the legs may occur, again because of decreased albumin levels in the body

Easy bruising or bleeding: The liver is responsible for producing blood clotting factors. Without an adequate supply, there is an increased risk of bleeding. Patients may have a low platelet count because of an enlarged spleen causing easy bruising.

Hepatic encephalopathy: The liver also helps remove waste products from the bloodstream. Ammonia is the chemical waste product of protein metabolism and the body requires a healthy liver to metabolize it. If ammonia levels rise, confusion and lethargy (encephalopathy) may occur.

Portal hypertension: An increase in pressure within the liver can cause blood flow issues leading to portal hypertension. This may backup blood flow from other organs, causing splenomegaly, an enlarged spleen, and varices, swollen veins, especially in the esophagus and stomach that can predispose to bleeding.

Osteoporosis: PBC is also complicated by osteoporosis, difficulty in absorbing nutrients, such as fat-soluble vitamin D and calcium, from the intestine.

Cancer: Some studies show patients with PBC are at an increased risk for hepatocellular carcinoma.

Since the cause of the disease is not known, it is not possible to prevent PBC. Allopathic drugs just slow down the progression of the disease and control the symptoms; While Homeopathic medication has best results.

PBC is a progressive disease, its depends on the doctor if he/she wants to controlled the disease or to cure with proper medicines (Homeopathic). The prognosis depends upon the treatment.

Proper Homeopathic Treatment

Cardus Marianus

The action of Cardus Marianus is centered in the liver, and portal system, causing soreness, pain, jaundice. Has specific relation to the vascular system. Abuse of alcoholic beverages, especially beer. Varicose veins and ulcers. Diseases of miners, associated with asthma. Dropsical conditions depending on liver disease, and when due to pelvic congestion and hepatic disease. Disturbs sugar metabolism. Influenza when liver is affected. Debility. Hemorrhages, especially connected with hepatic disease, dropsical accumulation of water in abdomen (ascites).

The next field is bleeding consequent to liver damage, liver pain and sensitiveness, feel fatigued or tired and have bouts of nausea and vomiting due to Liver Cirrhosis. Taste bitter. Aversion to salt meat. Appetite small; tongue furred; nausea; retching; vomiting of green, acid fluid. Stitches in left side of stomach, near spleen (Ceanoth). Gallstone disease with enlarged liver.

Pain in region of liver. Left lobe very sensitive. Fullness and soreness, with moist skin. Constipation; stools hard, difficult, knotty; alternates with diarrhea. Stools bright yellow. Swelling of gallbladder with painful tenderness. Hyperemia of liver, with jaundice. Cirrhosis, with dropsy.

Rectum: Hemorrhagic piles, prolapse or rectum, burning pain in anus and rectum, hard and knotting, clayey stools. Profuse diarrhea due to rectal cancer. 10 drops doses (Wapler).

Urine: Cloudy; golden-colored.

Skin: Itching on lying down at night. Varicose ulcers (Clematis vitalba). Eruption on lower part of sternum.

Extremities: Pain in hip-joint, spreading through buttocks and down thigh; worse from stooping. Difficult rising. Weakness felt in feet, especially after sitting.

Chelidonium Majus

A prominent liver remedy, covering many of the direct reflex symptoms of diseased conditions of that organ. The jaundiced skin, and especially the constant pain under inferior angle of right scapula, are certain indications. Paralytic drawing and lameness in single parts. The great general lethargy and indisposition to make any effort is also marked. Ailments brought on or renewed by change of weather. Serous effusions. Hydrocele. Bilious complication during gestation.

Tongue yellow, with imprint of teeth; large and flabby (Merc; Hyd). Taste bitter, pasty. Bad odor from mouth. Prefers hot food and drink. Nausea, vomiting; better, very hot water. Pain through stomach to back and right shoulder-blade. Gastralgia. Eating relieves temporarily, especially when accompanied with hepatic symptoms.

Abdomen: Jaundice due to hepatic and gall-bladder obstruction. Gall-colic. Distention. Fermentation and sluggish bowels. Constriction across, as by a string. Liver enlarged. Gallstones (Berberis).

Urine: Profuse, foaming, yellow urine, like beer (Chenop) dark, turbid.

Stool: Constipation; stools hard, round balls, like sheep’s dung, bright yellow, pasty; clay-colored, stools float in water; alternation of diarrhea and constipation. Burning and itching of anus.

Skin: Dry heat of skin; itches, yellow. Painful red pimples and pustules. Old, spreading, offensive ulcers. Wilted skin. Sallow, cold, clammy.

Pain in nape. Stiff neck, head drawn to left. Fixed pain under inner and lower angle of right scapula. Pain at lower angle of left scapula. Pain in arms, shoulders, hands, tips of fingers. Icy coldness of tips of fingers; wrists sore, tearing in metacarpal bones. Whole flesh sore to touch. Rheumatic pain in hips and thighs; intolerable pains in heels, as if pinched by too narrow a shoe; worse, right. Feels paralyzed. Paresis of the lower limbs with rigidity of muscles.

Lycopodium

Corresponds to Grau ogle’s carbo-nitrogenous constitution, the non-eliminative lithaemic. Lycopodium is adapted more especially to ailments gradually developing, functional power weakening, with failures of the digestive powers, where the function of the liver is seriously disturbed. Atony. Malnutrition. Mild temperaments of lymphatic constitution, with catarrhal tendencies; older persons, where the skin shows yellowish spots, earthy complexion, uric acid diathesis, etc; also precocious, weakly children.

Dyspepsia due to farinaceous and fermentable food, cabbage, beans, etc. Excessive hunger. Aversion to bread, etc. Desire for sweet things. Food tastes sour. Sour eructation. Great weakness of digestion. Bulimia, with much bloating. After eating, pressure in stomach, with bitter taste in mouth. Eating ever so little creates fullness. Wakes at night feeling hungry. Hiccough. Incomplete burning eructation rise only to pharynx there burn for hours. Likes to take food and drink hot. Sinking sensation; worse night. kidney affections, red sand in urine, pain in renal region; worse before urination. Intolerant of cold drinks. Best adapted to persons intellectually keen, but of weak, muscular power.

Deep-seated, progressive, chronic diseases. Carcinoma. Emaciation. Debility in morning. Marked regulating influence upon the glandular (sebaceous) secretions. Pre-senility. Ascites, lacks vital heat (immune system); has poor circulation, cold extremities. Pains come and go suddenly. Sensitive to noise and odors. Cirrhosis of Liver when the liver has atrophied due to long-standing Cirrhosis. Hepatitis may be predominantly present.

Abdomen is bloated, full. Constant sense of fermentation in abdomen, like yeast working; upper left side. Hernia, right side. Liver sensitive. Brown spots on abdomen. Dropsy, due to hepatic disease. Hepatitis, atrophic from of nutmeg liver.

Stool: Diarrhea. Inactive intestinal canal. Ineffectual urging. Stool hard, difficult, small, incomplete. Hemorrhoid; very painful to touch, aching.

Urine: Pain in back before urinating; ceases after flow; slow in coming, must strain. Retention. Polyuria during the night. Heavy red sediment.

Arsenic Album

A profoundly acting remedy on every organ and tissue. Its clear-cut characteristic symptoms and correspondence to many severe types of disease make its homeopathic employment constant and certain.

Liver Cirrhosis with fatigue as the main symptom. The patient feels totally exhausted from doing a little labor. Cannot bear the sight or smell of food. Great thirst; drinks much, but little at a time. Nausea, retching, vomiting, after eating or drinking. Anxiety in pit of stomach. Burning pain. Craves acids and coffee. Heartburn; gulping up of acid and bitter substances which seem to excoriate the throat. Long-lasting eructation. Vomiting of blood, bile, green mucus, or brown-black mixed with blood. Stomach extremely irritable; seems raw, as if torn. Gastralgia from slightest food or drink. Dyspepsia from vinegar, acids, ice-cream, ice-water, tobacco. Terrible fear and dyspnea, with gastralgia; also faintness, icy coldness, great exhaustion. Malignant symptoms. Everything swallowed seems to lodge in the esophagus, which seems as if closed and nothing would pass. Ill effects of vegetable diet, melons, and watery fruits generally. Craves milk.

Gnawing, burning abdominal pains; relieved by heat. Liver and spleen enlarged and painful. Ascites and anasarca. Abdomen swollen and painful. Pain as from a wound in abdomen on coughing.

Rectum: Painful, spasmodic protrusion of rectum. Tenesmus. Burning pain and pressure in rectum and anus.

Stool: Small, offensive, dark, with much prostration. Worse at night, and after eating and drinking; from chilling stomach, alcoholic abuse, spoiled meat. Dysentery dark, bloody, very offensive. Cholera, with intense agony, prostration, and burning thirst. Body cold as ice (Verat). Hemorrhoid burn like fire; relieved by heat. Skin excoriated about anus.

Urine: Scanty, burning, involuntary. Bladder as if paralyzed. Albuminous. Epithelial cells; cylindrical clots of fibrin and globules of pus and blood. After urinating, feeling of weakness in abdomen. Bright’s disease. Diabetes.

Nux Vomica

Nux Vomica is greatest of polychrest. Liver Cirrhosis who have a history of long-term alcoholic abuse, chronic acidity and constipation. Sour mouth taste, and nausea in the morning, after eating. Weight and pain in stomach; worse, eating, some time after. Flatulence and pyrosis. Sour, bitter eructation. Nausea and vomiting, with much retching. Ravenous hunger, especially about a day before an attack of dyspepsia. Region of stomach very sensitive to pressure. Epigastrium bloated, with pressure s of a stone, loves fats and tolerates them well. Dyspepsia from strong tea and/or coffee. Difficult belching of gas. Wants to vomit, but cannot. soreness or stitching pain in liver region.

Inclination to take highly spicy diet, stimulants (tea, coffee, alcoholic drinks and fat etc). Mentally anger some and irritable nature, being sensitive to external impressions like noise and odor and also, a sensitivity to cold air.

Bruised soreness of abdominal walls. Flatulent distension, with spasmodic colic. Colic from uncovering. Liver engorged, with stitches and soreness. Colic, with upward pressure, causing short breath, and desire for stool. Weakness of abdominal ring region. Strangulated hernia. Forcing in lower abdomen towards genitals. Umbilical hernia of infants.

Stool: Constipation, with frequent ineffectual urging, incomplete and unsatisfactory; feeling as if part remained un expelled. Constriction of rectum. Irregular, peristaltic action; hence frequent ineffectual desire, or passing but small quantities at each attempt. Absence of all desire for defecation is a contra-indication. Alternate constipation and diarrhea-after abuse of purgatives. Urging to stool felt throughout abdomen. Itching, blind hemorrhoids, with ineffectual urging to stool; very painful; after drastic drugs. Diarrhea after a debauch; worse, morning. Frequent small evacuations. Scanty stool, with much urging. Dysentery; stools relieve pains for a time. Constant uneasiness in rectum. Diarrhea, with jaundice.

Urine: Irritable bladder; from spasmodic sphincter. Frequent calls; little and often. Hematuria. Ineffectual urging, spasmodic and strangury. Renal colic extending to genitals, with dribbling urine. While urinating, itching in urethra and pain in neck of bladder.

Phosphorus

Phosphorus is a destructive metabolism. Causes yellow atrophy of the liver and sub-acute hepatitis, jaundice in patients with Cirrhosis of Liver, stool very offensive, vomiting of blood, desire for cold drinks, juices and ice creams.

Hunger soon after eating. Sour taste and sour eructation after every meal. Belching large quantities of wind, after eating. Throws up ingests by the mouthfuls. Vomiting; water is thrown up as soon as it gets warm in the stomach. Postoperative vomiting. Cardiac opening seems contracted, too narrow; the food scarcely swallowed, comes up again. Pain in stomach; relieved by cold food, ices. Region of stomach painful to touch, or on walking. Inflammation of stomach, with burning extending to throat and bowels. Bad effects of eating too much salt.

Abdomen feels cold. Sharp, cutting pains. A very weak, empty, gone sensation felt in whole abdominal cavity. Liver congested. Acute hepatitis. Fatty degeneration (Carbon tetrachloride; Ars. Chlorof). Jaundice. Pancreatic disease. Large, yellow spots on abdomen.

Stool: Very fetid stools and flatus. Long, narrow, hard, like a dog’s and difficult to expel. Desire for stool on lying especially on left side. Painless, copious debilitating diarrhea. Green mucus with grains like sago. Involuntary; seems as if anus remained open. Great weakness after stool. Discharge of blood from rectum, during stool. White, hard stools. Bleeding hemorrhoid.

Urine: Hematuria, especially in acute Bright’s disease. Turbid, brown, with red sediment.

Apocynum Cannabinum

Increases secretions of mucous and serous membranes and acts on cellular tissue, reducing edema and dropsy.

Nausea, with drowsiness. Thirst on walking. Excessive vomiting. Food or water is immediately ejected. Dull, heavy, sick feeling. Oppression in epigastrium and chest, impeding breathing (Lobelia infl). Sensation of sinking in stomach. Abdomen bloated. Ascites.

Stool: Watery, flatulent, with soreness in anus; worse after eating. Feeling as if sphincter were open and stools ran right out.

Urine: Bladder much distended. Turbid, hot urine, with thick mucus and burning in urethra, after urinating. Little expulsive power. Dribbling. Strangury. Renal Dropsy.

Quassia Amara

Acts on gastric organs as a tonic. Seems to possess marked action on eyes, producing amblyopia and cataract. Pain in right intercostal muscles above the liver. Pressure and stitches in liver, and sympathetically in spleen.

Stomach: Atonic dyspepsia, with gas and acidity. Heart-burn and gastralgia. Regurgitation of food. Abdomen feels empty and retracted. Dyspepsia after infectious diseases; especially grip, dysentery. Tongue dry or with brown sticky coating. Cirrhosis of liver with ascites.

Urinary: Excessive desire-impossible to retain urine; copious micturition day and night. As soon as the child wakes up the bed is drenched.

Inclination to yawn and stretch. Sensation of coldness over back. Prostration, with hunger. Cold extremities, with sensation of internal coldness.

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