Treatment of Primary Biliary Cholangitis (Primary Biliary Cirrhosis)

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How do doctors treat primary biliary cholangitis?

Doctors treat primary biliary cholangitis with medicines. Your doctor may prescribe ursodiol. Although ursodiol does not cure primary biliary cholangitis, it can slow the progression of liver damage. People who respond to ursodiol early in the course of primary biliary cholangitis can live longer without needing a liver transplant.

If you do not respond to ursodiol, your doctor may prescribe obeticholic acid. Although obeticholic acid may improve blood test results, it may worsen symptoms. Obeticholic acid has not been shown to improve the course of illness or prevent cirrhosis. People with cirrhosis should not use obeticholic acid because it can cause worsening of disease.

An open hand holding two medicine capsules.Doctors treat primary biliary cholangitis with medicines.

How do doctors treat the symptoms of primary biliary cholangitis?

Your doctor may recommend over-the-counter medicines or prescribe medicines to treat symptoms of primary biliary cholangitis, such as itchy skin.

How do doctors treat the complications of primary biliary cholangitis?

Doctors may treat common complications of primary biliary cholangitis with medicines, dietary supplements, or changes in your diet and lifestyle.

  • If you have higher-than-normal blood cholesterol levels, your doctor may prescribe medicines called statins and recommend lifestyle changes.
  • For osteoporosis, your doctor may prescribe medicines that slow or stop bone loss and improve bone density. Your doctor may recommend dietary supplements of calcium and vitamin D.
  • For low levels of fat-soluble vitamins, your doctor may recommend dietary supplements of vitamins A, D, E, and K. Follow your doctor’s instructions on the type and amount of vitamins you should take.
  • If you have dry eyes and dry mouth due to Sjögren’s syndrome, you should have regular eye and dental examinations.

Liver complications

Doctors may recommend additional treatments for liver complications of primary biliary cholangitis.

Cirrhosis or portal hypertension. If primary biliary cholangitis leads to cirrhosis or portal hypertension, doctors can treat the health problems related to these conditions with medicines, minor medical procedures, and surgery.

Liver failure. If cirrhosis leads to liver failure, you may need a liver transplant.

Liver cancer. If you have cirrhosis or other risk factors, your doctor may suggest blood tests and an ultrasound or another type of imaging test to check for liver cancer. Finding cancer at an early stage improves the chance of curing the cancer.

When do doctors consider a liver transplant for primary biliary cholangitis?

Your doctor will consider a liver transplant when your primary biliary cholangitis leads to liver failure. Doctors consider liver transplants only after they have ruled out all other treatment options. Talk with your doctor to find out whether a liver transplant is right for you.

What can I do to help prevent further liver damage?

If you have primary biliary cholangitis, you can take steps to help prevent further liver damage. For example, you can

  • carefully follow your doctor’s instructions and take your medicines and dietary supplements as directed.
  • quit smoking.
  • avoid drinking alcohol. If you have cirrhosis, completely stop drinking alcohol.
  • have regular checkups, as recommended by your doctor.
  • talk with your doctor before taking
  • try to reach and stay at a healthy body weight.
Last Reviewed March 2021
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This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.