The two primary symptoms of primary biliary cholangitis (PBC) are pruritus (itchy skin) and fatigue.
Mild cognitive impairment, also known as brain fog, is another common symptom. It refers to short-term memory lapses or difficulty concentrating or processing information and creates a general feeling of mental fogginess.
There is no cure for PBC, so long-term symptom management is an important part of disease management.
What is PBC?
Primary biliary cholangitis (PBC) is a rare, chronic autoimmune disease that primarily affects the liver. In PBC, the body’s immune system mistakenly attacks the small bile ducts within the liver, causing inflammation and gradual destruction of these ducts. Bile, a substance essential for digesting fats and removing toxins, becomes trapped in the liver, leading to liver damage over time.
The effect of a PBC diagnosis on quality of life
Some PBC patients may experience no symptoms and are surprised when a PBC diagnosis is made. PBC may be detected when blood tests are done for other reasons or as part of a routine examination. It is then confirmed with a liver biopsy.
See more about PBC treatment and care
Early PBC symptoms of pruritus and fatigue may also be attributed to stress or other lifestyle and environmental factors before a formal diagnosis. Similarly, fatigue and mild cognitive impairment may also be attributed to hormonal changes if the PBC patient is a middle-aged woman.
As the disease progresses, the symptom burden may become more pronounced, negatively affecting a patient’s well-being and quality of life. Other symptoms may include dry eyes and mouth, and bone or joint pain.
What causes mild cognitive impairment?
More research is needed to fully understand the exact connection between liver disease and mild cognitive impairment. But it is thought that a poorly functioning liver cannot eliminate toxic substances such as ammonia, which develops in the intestines, and may affect the brain and cause confusion. It is thought to occur in 33% of people living with PBC.
Managing mild cognitive impairment
The combination of pruritus, fatigue and cognitive impairment can contribute to feelings of social isolation and depression. There is currently no medication available to treat cognitive impairment related to PBC.
To live successfully with PBC, it is essential to make changes to diet and lifestyle to reduce the burden of symptoms.
By collaborating closely with your health care team, you will be able to combine medication to boost your liver function and manage specific symptoms with the following diet and lifestyle modifications.
In general, the following may improve a PBC patient’s quality of life.
- Reduce salt in your diet.
- Eat a healthy balanced diet.
- Stay hydrated.
- Exercise regularly, including yoga and meditation to reduce anxiety and boost your mood.
- Take regular vitamin supplements, such as iron and vitamin D.
To manage brain fog specifically, experts recommend doing the following.
- Mild cognitive impairment means often forgetting details, so get in the habit of writing everything down.
- Establish a structured routine, and communicate it to your friends and family.
- Be kind to yourself and understand that your forgetfulness is not your fault. Stressing about the details won’t help you in managing your symptoms.
Finally, keep a symptom log and share it with your doctor. It may help you identify where you need to readjust your approach to live better with PBC.
