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Biliary CirrhosisBiliary Cirrhosis – General InformationBiliary Cirrhosis is a disorder in which the bile ducts in the patient’s liver are slowly destroyed. The human body has an intricate system of ducts which are supposed only to transport the bile, the fluid that is produced by the patient’s liver. Bile is very important as it ensures a good digestion of fats and it helps rid the body of the dead red blood cells, cholesterol and any other potential toxins. In this kind of the disease, the destruction of the bile ducts can lead to the unwanted build up of several toxic substances in the patient’s liver. In some cases, this disorder leads to an irreversible scarring of liver tissue, called cirrhosis. The cause of Biliary Cirrhosis still remains unknown. Several scientists consider this type of disease an autoimmune disorder in which the human body turns against its own cells, but others consider that it is likely that genetic and environmental factors play an important role in the development of the disease. This condition is a type of disease that develops slowly and medication can only slow the evolution of the disease, particularly if treatment begins in an early stage. The destruction of the existing liver tissue that happens in this type of disease greatly increases the risk of developing liver cancer or primarily hepatocellular carcinoma, in which the hepatocytes are affected, the most important type of liver cell. If the disease is not treated in time, the late stage of the disease can lead to the appearance of the osteoporosis, which is considered the main complication of this medical condition.Biliary Cirrhosis – SymptomsThe symptoms of this type of the disease can differ depending on the stage of it, early or late. In the early stage of the disease, some patients suffering of Biliary Cirrhosis have almost no symptoms for years after they are diagnosed but others can experience symptoms such as fatigue, itching, dry eyes and dry mouth. Fatigue is the most encountered symptom of Biliary Cirrhosis. In most of the cases, energy levels are just fine in the morning, but can decrease later in the day and do not improve with rest. Experts have not found any correlation between the level of exhaustion and the severity of the disease. Itching is another symptom, which is usually most painful over the patient’s legs, arms and back. The intensity of itching can vary, usually becoming worse at night and improving during the day. Nighttime itching can interrupt the sleep, making the fatigue symptom worse and, in some cases, causing Depression. Dry eyes and mouth, or sicca syndrome usually appears in patients with other autoimmune disorders and causes inflammation inside the moisture secreting glands of the eyes or mouth, causing a low production of tears or saliva. This can also cause difficulty in swallowing, light sensitivity and corneal ulcers. In the late stage of the disease, the main symptoms are considered to be xanthomas (cholesterol deposits). The human body uses bile as the main way of destroying the excess cholesterol. When the disease gets in this process the level of cholesterol in the blood increases and can lead to the appearing of fatty deposits in the skin around the eyes, the eyelids, or in the creases in the palms, soles, elbows or knees.Biliary Cirrhosis – TreatmentBecause there is no cure for Biliary Cirrhosis, the treatment has the goal of slowing the evolution of the disease and relieving any existing symptoms and also preventing possible complications. To treat the disease, there are some treatments which have the effect of slowing the evolution of the disorder and of prolonging the patient’s life. Such treatments include ursodeoxycholic acid, several other drugs and even liver transplant. Ursodeoxycholic acid or UDCA is usually used to cure gallstones, and it can work by attacking the body's bile acids and reducing the inflammation. This type of medicine is not able to cure Biliary Cirrhosis, but it can prolong the patient’s life if it is administered in an early stage of the disease. This medicine is considered the first step of any therapy for this disease. It is less possible to help cure people who are suffering from severe liver damage. However, such a treatment does not help in relieving the symptoms, it does not improve fatigue, which is the most encountered and often the most disabling symptom of the condition. The most common side effect of this kind of treatment is considered to be diarrhea, and in some cases side effects can include aches and pains and trouble in swallowing. For treating the disease, doctors can also prescribe medical trials including medicines and in some cases other drugs can be used off-label to treat this type of the disease, but almost all of them have proved to cause severe side effects. Many studies have shown that the drug prescribed as methotrexate, which is generally used to treat disorders such as arthritis, psoriasis and many kinds of cancer, can make Biliary Cirrhosis worse. Liver transplant can be an effective surgical approach when others treatments no longer control the disease and the liver starts to fail, and it can help prolong the patient’s life. Most doctors use a mathematical technique to help determine what patient will benefit from a liver transplant. No treatment is able to relieve most of this disorder’s symptoms (fatigue, for example); even if many therapies can be used to help control the intense itching that usually appears in Biliary Cirrhosis. Cholestyramine and Colestipol belong to a special type of cholesterol lowering drugs which can provide a big relief of itching in some patients, but they can also have many drawbacks. Cholestyramine is an unpleasant-tasting powder which has to be mixed with food or liquids and it can be severely constipating. In addition to this, these drugs can interfere with how the patient’s body metabolizes UDCA, several other medications, and hormones or some vitamins. Rifampin is a drug which is usually prescribed for patients who can't tolerate the side effects of cholestyramine. Rifampin isn’t effective for all patients and it is slow acting - in some cases, it can take about a month to have any effect. It can also lead to severe side effects or toxic reactions. |
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