Around half of all cases of primary biliary cirrhosis (PBC) have no symptoms until extensive liver damage has already occurred. This type of PBC is known as asymptomatic PBC.
Early-stage PBC
In people with symptoms, the most commonly reported symptoms of PBC are:
- chronic fatigue (extreme tiredness) – this is the most common symptom; many people feel sleepy during the day
- itchy skin (ranging from mild to severe) – this can be widespread or it can only affect a single area; it may be worse at night when in bed, when in contact with fabrics, when warm or if pregnant
- dry eyes and mouth
There is often no association between the severity of symptoms and the degree of underlying liver damage. For example, some people with PBC have severe symptoms of fatigue and itchy skin, yet further tests show that their liver is not severely damaged. In other people with either no or mild symptoms, tests reveal extensive liver damage. As with many aspects of PBC, the reasons for this are unclear.
Advanced PBC
After PBC has caused extensive damage to the liver, there will be additional symptoms as a result of the liver not working as well as it should. These symptoms include:
- jaundice – yellowing of the skin and the whites of your eyes
- build-up of fluid in the legs, ankles and feet (oedema)
- build-up of fluid in your abdomen that can make you look heavily pregnant (ascites)
- the formation of small fatty deposits on the skin, usually around your eyes (xanthelasmata)
- diarrhoea – your stools may have a particularly unpleasant smell
Progression
Some studies have suggested that people with asymptomatic PBC may survive longer than those with symptoms. However, in general, the progression of PBC varies between individuals. Medication can now help delay serious damage to the liver.
