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Type A and Primary Biliary Cirrhosis


QUESTION

What can I do, I have Primary Biliary Cirrhosis? You are the first person I have seen who mentions that there is treatment and hope for it. I am type A and am switching to the diet you recommend, What else?


ANSWER

Primary biliary cirrhosis (PBC) is a disease characterized by inflammatory destruction of the small bile ducts within the liver. PBC eventually leads to cirrhosis of the liver. The cause of PBC is unknown, but because of the presence of autoantibodies, it is generally thought to be an autoimmune disease. Other etiologies, such as infectious agents, have not been completely excluded. PBC has a worldwide prevalence of approximately 5/100,000 and an annual incidence of approximately 6/1,000,000. The prevalence and incidence appear to be similar in different regions of the world. About 90% of patients with PBC are women. Most commonly, the disease is diagnosed in patients between the ages of 40 and 60 years.

Most patients with PBC present with pruritus (itching). After pruritus, jaundice (yellow skin caused by bilirubin retention) is the most common presenting symptom. Several patients also present with complaints related to chronic portal hypertension (increased blood pressure in the veins that go to the liver that can lead to symptoms such as bleeding in the esophagus or fluid retention in the abdomen). Some patients are discovered to have PBC during workup of another illness. Since the widespread use of routine serum biochemical analysis, many patients present for evaluation of an elevated serum alkaline phosphatase activity that was detected on laboratory examination.

Patients with PBC have abnormalities in several blood tests. In essentially all patients, the serum alkaline phosphatase and gamma-glutamyltranspeptidase activities are markedly elevated (these are enzymes present in the bile ducts). Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities are usually moderately elevated (these are enzymes made by hepatocytes, the predominant liver cell type).

My suggestions

  • Low protein diet. This may be moot, since most people with PBC are blood group A, so what I am really saying is follow the type A diet.


  • Fat soluable vitamins. Fat absorption becomes compromised with PBC, so adequate supplementation with vitamins A, E, K and D is important.


  • Liver-specific antioxidants. Milk Thistle, the Ayurvedic herb Eclipta alba, Lipoic acid, can help minimize free-radical damage to the bile ducts.


  • Vitamin C and bioflavanoids. The water soluable antioxidants can help matian the elasticity of the veins, which are often de-natured by the excessive high portal pressure due to the congestion of the liver.


  • PBC is a progressive disease, but with good diet and rational supplementation you can control it effectively -hopefully until better allopathic treatment is available.

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    The Ask Dr. D'Adamo internet advice column ran from 1996 to 2009, at which time Dr. D'Adamo's teaching and programming responsibilities no longer allowed him to devote time and resources to directly answering visitor questions. However we've recently reorganized this treasure-trove of material and made it again available to his readership. He occasionally posts new entries. These are marked with a NEW tag.



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