Most patients remain without symptoms for many years, and some may never notice any symptoms. The initial symptoms vary among PBC patients, and the varying symptoms can sometimes make it difficult for doctors to actually diagnose PBC. The varying symptoms may be do to the individual, autoimmune nature or other diseases associated with PBC.
First symptoms noticed by most PBC patients, many times prior to diagnosis. Symptoms may be present in any combination and include any of the following:
- Dry eyes, can feel like sand in eyes.
- Dry mouth, sometimes referred to as cotton mouth.
- Fatigue may be the first symptom the patient notices, causing him or her to visit their doctor. The fatigue associated with PBC appears to be totally different from any other sort of fatigue. In early stages, many patients have commented they could sleep for hours. While some in the later stages say sleeping becomes more difficult. At this time, there is little research into the cause and treatment of the liver disease fatigue. It is usually not due to depression, and some researchers believe it is an abnormality of the axis between the pituitary and the adrenal glands. Support and understanding from family members, friends and the doctor is very important, making it somewhat bearable.
- Itching of the skin can be intense and unrelenting. In some it is debilitating. Many patients say itching feels like tiny bugs crawling under the skin. In some cases heat has helped.
PBC patient may start noticing other symptoms:
- Abdominal pain or pressure in the liver area. (Yes it’s real)
- Arthritic aches and pains in bones, muscles and joints are common. In some, the pains can be severe and debilitating. Some even report severe pain just touching leg, feet and hip bones, but this is NOT common.
- Dental problema
- Diarrhea that can be greasy (steatorrhea)
- Difficulty sleeping and changes in sleeping habits. Some PBC patients have noted that itching intensifies when they lay down to sleep, and those who have liver pain say it is more severe in a sleeping position.
- Elevated cholesterol
- Gradual darkening (hyperpigmentation) or changes in skin texture, and various skin rashes.
- Reflux and stomach ulcers.
- Small yellow or white bumps (xanthomas) under the skin, or around the eyes.
- Thyroid problems.
Over the years, as the PBC progresses, other symptoms may appear. These symptoms may include any of the following:
- Enlarged abdomen from fluid accumulation.
- Easy bruising or bleeding.
- Fever .
- Hepatic encephalopathy causing personality changes: dulling of mental functions, neglect of personal appearance, forgetfulness and trouble concentrating, changes in sleeping habits, confusion, breath odor and muscle stiffness. Encephalopathy occurs in final stage of PBC.
- Hepatorenal syndrome, progressive deterioration of kidney function leading to kidney failure in a person with liver failure.
- Hepatopulmonary syndrome, associated with difficulty with breathing.
- Hypersplenism, enlarged spleen
- Increased bilirubin.
- Internal bleeding in upper stomach and esophagus, that may be caused by varcies.
- Jaundice (yellowing of the skin and eyes).
- Liver cancer (hepatocellular carcinoma).
- Nausea & vomiting.
- Osteoporosis or other metabolic bone disease.
- Sexual problems (impotence in men, absence of periods in women, dryness, lack of desire.)
- Swelling of the hands, legs and ankles. See edema and ascites.
- Trembling hands.& legs.
- Weight increase or decrease
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