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Primary biliary cholangitis: the signs, the tests, treatment, and day to day
For anyone told a blood test shows a high alkaline phosphatase or anti-mitochondrial antibodies; for anyone who is tired all the time and itches; for anyone just told they have primary biliary cholangitis (PBC, once called primary biliary cirrhosis), or taking ursodiol for it; and for the people who love them. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK, part of the NIH) says it is a chronic disease in which the small bile ducts in the liver are slowly destroyed, that many people have no symptoms when it is found, and that ursodiol can slow the damage. This page passes on, by name, what NIDDK says: the signs and when it cannot wait, who gets it and what can come with it, the tests, the medicines and what has changed since NIDDK wrote about them, the itch and the complications, and protecting your liver, food, bones and vitamins. It builds the words to say to a doctor, and prints a card to carry.
Right now
- Someone with liver disease is vomiting blood, is confused or very hard to wake, or has fainted? NIDDK names internal bleeding from burst veins, and confusion, among the complications. Call 911 (ours). Do not drive yourself.
- New yellow eyes or skin? NIDDK names it among the signs as the disease gets worse. See a doctor the same day (ours).
- You take a medicine for PBC and want to stop or change it? NIDDK says to follow your doctor’s instructions and talk with your doctor before taking any medicine or supplement. Ask first (ours).
- It is all too much, or you are thinking of ending your life? Call or text 988, any hour (ours).
More help
- The liver, on this site: Cirrhosis · Autoimmune hepatitis · Fatty liver disease · Gallstones · GI bleeding · An upset stomach: find the right page.
- What can come with it, as NIDDK names it: Underactive thyroid · Scleroderma · Dry eye · Arthritis · Bladder infection · High cholesterol · Osteoporosis.
- Day to day: My medicines list · Symptom diary · Quit smoking · Get ready for your appointment.
- Care and costs: When you can’t afford your medicine · When you need a doctor and can’t pay · When a medical bill is too much.
- In a crisis: Help right now (988, 911). All our free tools.
An upset stomach, and not sure this is the right page? The pages on this site for throwing up, diarrhea, heartburn and constipation, on one list.
This page and its wording were written with AI (Claude) for Scarlet Beast (our AI policy). No doctor or nurse has reviewed it. The facts were read on October 17, 2026 on NIDDK’s Primary Biliary Cholangitis pages (NIH): the overview, Definition & Facts, Symptoms & Causes, Diagnosis, Treatment and Eating, Diet, & Nutrition, and their Spanish versions; all were last reviewed in March 2021 and say the same things. Because those pages are older, we also read the FDA’s list of withdrawn accelerated approvals (current as of February 25, 2026), which shows obeticholic acid’s approval for PBC withdrawn on November 24, 2025. Ours: 911 for vomiting blood, confusion, someone very hard to wake, or fainting; a doctor the same day for new yellow eyes or skin; calling the doctor soon for swelling or an itch that keeps you awake; bringing a list of everything you take; asking before you stop or change a medicine; the card; 988 when it is too much; health centers when money is tight; and the order of the steps. What we left out: brand names, doses, newer medicines no page we read names, research studies, and clinical pages for providers. This page saves nothing and loads no trackers.