Primary biliary cirrhosis 


Liver health: an animation

An educational animation on liver health and disease prevention. Inspired by Jazzy, a teenager living with hepatitis C.

Media last reviewed: 16/05/2013

Next review due: 16/05/2015

Tiredness and fatigue

What makes you tired and how to boost your energy, with self-help tips and an energy diet

Primary biliary cirrhosis (PBC) is a long-term liver disease that damages the small bile ducts in the liver.

This gradually leads to a build-up of bile in the liver, which then damages the organ.

Symptoms of PBC often include:

  • fatigue (extreme tiredness)
  • itchiness of the skin
  • dry eyes and mouth

Read more about the symptoms of PBC.

Bile and bile ducts

Bile is a liquid produced inside the liver that is used by the digestive system to help digest fats and remove waste from the body. It is transported out of the liver into the small bowel through a series of small tubes called bile ducts.

In PBC, for reasons not fully understood, the immune system (the body's natural defence against infection and illness) gradually damages the bile ducts. Eventually, the damage leads to a blockage that obstructs the flow of bile. The amount of bile in the liver builds up to a dangerous level, causing scarring (cirrhosis).

Who is affected?

PBC is a rare liver condition. In England and Wales, PBC is estimated to affect one in every 3,000 people. However, the rates of PBC in England are higher than in some other parts of the world. The reason for this is unknown.

PBC mainly affects women (about 90% of all cases). The condition usually occurs in people aged 30-65, and is normally diagnosed after a person has reached 40.

The exact causes of PBC, and why it mainly affects women, are unknown.

Read more about the causes of PBC

Treating PBC

PBC is usually a progressive condition, which means damage to the liver can steadily get worse over time. The rate at which PBC progresses varies between individuals. It can take decades in many cases.

If not treated, the liver can become damaged to such an extent it no longer works. This is known as liver failure and can be fatal.

There is no cure for PBC, but there are medicines that help slow the progression of the condition and that help relieve the itchiness associated with it. In cases where there is extensive liver damage, a liver transplant may be required.

However, over the last 20 years, the need for liver transplants as a result of PBC has been decreasing. This may be due to the use of a medicine called ursodeoxycholic acid (UDCA).

Read more about how PBC is treated.

Page last reviewed: 07/11/2012

Next review due: 07/11/2014


How helpful is this page?

Average rating

Based on 81 ratings

All ratings

Add your rating


The 4 comments posted are personal views. Any information they give has not been checked and may not be accurate.

scattier said on 10 January 2014

I am interested in hearing more about the 'medicines that help relieve the symptoms' - the ursodeoxycholic acid treats the bile flow and questran is thought to relieve itching. But what about the other symptoms -especially fatigue. My understanding is that there is no treatment for those symptoms that has been shown to be effective and has been approved for use in PBC.

Report this content as offensive or unsuitable

malteaser1955 said on 27 October 2013

I was diagnosed over 10-years ago, at a time when I was seriously ill with serious fatigue and depression, itching, memory problems, plus Sjogrens syndrome and hiatus hernia. I also have Fibromyalgia. I was started on URSO immediately, and today my bi-annual blood tests show reduction in figures, itching improved immediately on taking URSO, I no longer worry about death so much, but I cannot work because the tiredness is too much of a problem. If I don't work, I am too tired. If I do work, I am even more tired, and end up in bed for weeks instead of just being tired. So, I don't do much and have some quality of life, if I overdo it, I don't have any quality, and end up in pain all over and seriously much worse until I manage to recover by resting. Everyone is different, never lose hope.

Report this content as offensive or unsuitable

loopydeb66 said on 13 December 2011

I so agree with you GINISIS. i seem to know more bout this disease than my consultant!! Ive found a few sites that have real people that live with this on a daily basis. Look on facebook
all have a good feeling when u join and u can find out from ppl who know tips on the tiredness, itching, memory etc

Report this content as offensive or unsuitable

genisis said on 18 July 2011

I wish my drs were more helpful,i know they don't know a lot about p.b.c just wish they were more understanding they have'nt time to let us say how we feel and some days i just feel really ill
just needed to say that

Report this content as offensive or unsuitable

Women's health 40-60

Healthy living advice for women aged 40 to 60. Includes real stories on losing weight and alcohol dangers

Find and choose services for Primary biliary cirrhosis