What are the complications of primary biliary cirrhosis?
The complications of primary biliary cirrhosis develop as the ability of the liver to function decreases. Cirrhosis describes liver scarring and failure. The liver is responsible for helping to digest food, producing proteins, blood clotting factors, and enzymes that help digest food. Some complications include the following:
Ascites: Fluid collection within the abdomen that occurs because the liver cannot produce enough albumin, a protein that helps keep fluid within the blood vessels. Ascites fluid is prone to infection and a condition called spontaneous bacterial peritonitis (peritoneum=sac that contains the abdominal organs + itis=inflammation)
Edema: Swelling of the legs may occur, again because of decreased albumin levels in the body
Easy bruising or bleeding: The liver is responsible for producing blood clotting factors. Without an adequate supply, there is an increased risk of bleeding. Patients may have a low platelet count because of an enlarged spleen causing easy bruising.
Hepatic encephalopathy: The liver also helps remove waste products from the bloodstream. Ammonia is the chemical waste product of protein metabolism and the body requires a healthy liver to metabolize it. If ammonia levels rise, confusion and lethargy (encephalopathy) may occur.
Portal hypertension: An increase in pressure within the liver can cause blood flow issues leading to portal hypertension. This may backup blood flow from other organs, causing splenomegaly, an enlarged spleen, and varices, swollen veins, especially in the esophagus and stomach that can predispose to bleeding.
Osteoporosis: PBC is also complicated by osteoporosis, difficulty in absorbing nutrients, such as fat-soluble vitamin D and calcium, from the intestine.
Cancer: Some studies show patients with PBC are at an increased risk for hepatocellular carcinoma.