A Review of Primary Biliary Cholangitis

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Primary Biliary Cholangitis (PBC) is a chronic liver disease that causes damage to the bile ducts in the liver. Read on to learn more about this condition.

Causes and Risk Factors

PBC is considered to be an autoimmune disease. This means your body perceives your liver as invasive and attacks it. Your body’s T cells, which fight off bacteria and viruses, end up damaging cells in the bile ducts in your liver.

This condition may be caused by environmental factors as well as genetic factors. It is more likely to occur in women, people between 30 and 60, people who smoke, people with a family member who has PBC, and people who have been exposed to certain chemicals. Sex is one of the primary risk factors: around 90% of people with PBC are women.

Symptoms

PBC causes a few symptoms. These include intense itching, elevated cholesterol levels, swollen feet and ankles, musculoskeletal pain, darkening of the skin, and abdominal pain. In general, these symptoms develop gradually, and most people with PBC do not have symptoms when doctors diagnose them with the condition. Symptoms tend to develop over 5 to 20 years, becoming more significant over time.

Diagnosing Primary Biliary Cholangitis

In most cases, doctors diagnose PBC incidentally during a routine checkup or other medical visit. This is because symptoms tend to develop very slowly, and are often not present in the early stages of the disease. In many cases, your doctor may discover an abnormal result in a routine blood test, which leads them to further testing. If they do suspect you may have PBC, they will likely give you a blood test to measure anti-mitochondrial antibodies (AMAs). Doctors consider this the go-to test for PBC, since people almost never have AMAs present in their blood unless they have PBC. If your doctor does discover AMAs through the testing, that is a sign you likely have the condition.

Your doctor will also ask you about your medical history, along with your family’s medical history. This is to help determine if the disease may be present in your family already, which is a risk factor for you having it.

Treating Primary Biliary Cholangitis

There is no cure for PBC, but there are several treatments doctors can pursue to help manage your symptoms and disease progression. Over the long term, PBC can lead to liver failure since it damages your liver slowly over many years. If your liver fails, you will need a liver transplant, which is a major surgery.

To help mitigate damage, your doctor may prescribe a medication called ursodiol. This is a natural bile acid that can help bile flow through your liver more effectively. It can improve your liver function and reduce scarring. It is an effective treatment for a little over half of people with PBC.

There are many treatment options to address the symptoms of PBC as well. Your doctor may recommend antihistamines like Benadryl to help with intense itching, and eye drops to help with dry eyes. They may also prescribe calcium and Vitamin D to help maintain your bone strength, and if you have fatty stools there are other vitamin supplements they may recommend.

There are a number of lifestyle changes you can make to help manage PBC as well. These include avoiding alcohol or lowering your intake, staying hydrated, exercising regularly, and avoiding smoking. You can combine these kinds of lifestyle changes with your medications to manage PBC and improve your health outlook long-term.

Our experienced team at GHP has years of experience treating patients with conditions including PBC. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Dyspepsia

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Dyspepsia, also known as indigestion, is a common condition. Here’s what you need to know.

Causes and Risk Factors of Dyspepsia

Dyspepsia can be caused by a number of things. Acid reflux and stomach ulcers can both irritate the lining of your stomach, leading to burning pain in your upper chest that is associated with indigestion. In the case of acid reflux, stomach acid backs up into your esophagus and causes indigestion. Some over the counter pain relievers like ibuprofen and aspirin can also cause similar issues.

Functional dyspepsia, which is recurring indigestion that doctors can’t find a clear cause for, has a number of risk factors. Women, people who smoke, people with anxiety or depression, and people with h. pylori infection tend to have a higher risk.

Symptoms

In general, there are a few symptoms that define this condition. These include a burning pain in the upper abdomen, bloating, feeling full quickly while eating, nausea, and vomiting. In many cases, these symptoms can occur after eating. However, they may also occur at other times. Most of the time symptoms are intermittent, tending to come and go.

There are a few serious symptoms to look out for. If you experience shortness of breath, bloody vomit, unexplained weight loss, or tarry stools, seek medical attention as soon as you can. These can be signs of more serious conditions.

Diagnosing Dyspepsia

Since indigestion can be caused by so many things, your doctor diagnosis it by first talking through your symptoms and medical history. They may perform diagnostic testing to figure out the exact cause as well. These tests may include blood tests, breath testing, or stool tests if they suspect a bacterial infection could be present. They can also perform an upper endoscopy to visualize your upper digestive tract and identify the cause of your indigestion. During this procedure, they may also take a biopsy to get a closer look at any potential issues.

Treatment and Prevention

There are several lifestyle changes and medications that can help with dyspepsia. Your doctor may recommend quitting smoking, eating smaller meals slowly throughout the day, avoiding caffeine and alcohol, and managing stress and anxiety. You may also try to avoid foods that tend to cause your symptoms. If stress, anxiety, or depression seems to be a cause of your symptoms, you may consider working with a therapist or another mental health professional to develop skills that improve your mental health. All of these behaviors can help improve your symptoms. They are also important preventative steps you can take to prevent dyspepsia from recurring long-term.

Your doctor may also recommend over the counter or prescription medication to help. The specific medication they recommend will depend on your symptoms. This can help with everything from acid reflux, bloating, nausea, and gas to depression and anxiety.

Our experienced team at GHP has years of experience treating patients with conditions including dyspepsia. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Colonic Ischemia: What You Need to Know

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Colonic ischemia is a condition where blood flow in the colon is reduced. It can cause damage to the affected area of the colon. Here’s everything you need to know about this condition. 

Causes and Risk Factors

Colonic ischemia, as noted above, causes diminished blood flow in the colon. This can be caused by a number of things. Your risk increases if you have fatty buildups on an artery wall (atherosclerosis), extremely low blood pressure (often due to trauma, shock, surgery, or heart failure), or use cocaine or methamphetamine. Some disorders like lupus and sickle cell anemia can also be a cause of this condition. 

Colonic ischemia is more common in adults over 60 and in women. If you have had abdominal surgery, scar tissue from the procedure can also reduce blood flow in some cases. Additionally, people with IBS are more likely to develop colonic ischemia. 

Symptoms of Colonic Ischemia

Some of the most typical symptoms involved with this condition include abdominal pain or tenderness. This can be severe in some cases, and may also build gradually or occur suddenly. You can experience symptoms on the right or left side of your abdomen. Other symptoms also include nausea, vomiting, diarrhea, blood in your stool, and a feeling of urgency to defecate. 

Diagnosis

This condition is difficult to diagnose because its symptoms are also associated with a number of other disorders. Doctors diagnose colonic ischemia with a combination of medical history, a physical exam, and some testing procedures. They often start by charting your symptoms and identifying any potential risk factors. Your doctor may also check your abdominal area to identify the location of any pain. They may choose to order a CT scan to help visualize your colon and identify the cause of the symptoms. They may also perform a sigmoidoscopy or colonoscopy to see detailed images of your colon and potentially take a tissue biopsy. All of these tests are ways they can get at the underlying cause of your symptoms.  

Treating Colonic Ischemia

Doctors treat this condition by helping proper blood flow return to the colon. In milder cases, this may just involve an IV to help you rehydrate. Your doctor may also prescribe antibiotics to prevent infections, and may suggest you avoid medications that constrict your blood vessels. If there is a specific underlying disorder that has caused colonic ischemia (like an irregular heartbeat), your treatment will involve treating that disorder. 

In some cases, you may also need surgery to heal. This is for severe cases where your colon has undergone significant damage. Depending on your situation, doctors may repair any holes in your colon, remove dead tissue, or remove a portion of your colon. 

Our experienced team at GHP has years of experience treating patients with conditions including colonic ischemia. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Anal Fissures: An Overview

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An anal fissure is a tear or rip in the lining of the anal canal. Here’s what you need to know about anal fissures.

Causes and Risk Factors

Anal fissures are most often caused by trauma in the anal canal. They can be caused by straining during a bowel movement, chronic diarrhea, anal intercourse, childbirth, and anything else that may cause trauma in the canal. Anal fissures are most common in infants, but can occur at any age. Other risk factors include childbirth, constipation, and crohn’s disease.

Symptoms of Anal Fissures

This condition is characterized by a few symptoms. The most common symptoms include pain and bleeding with bowel movements. You may experience pain during and after a bowel movement, even hours later, with an anal fissure. Many people with this condition may notice blood on the outer surface of stool or blood on toilet paper after a bowel movement. Other symptoms can include a visible crack around the anus, burning and itching, constipation, and foul-smelling discharge around the fissure.

Diagnosis

Doctors diagnose anal fissures with a physical examination and asking about your medical history. They examine your anal region and look for a visible tear that indicates a fissure. They may be able to determine the nature of the fissure during the examination as well. An acute fissure will likely look like a fresh and more shallow tear, whereas a chronic case may have a deeper tear. Chronic anal fissures last longer than eight weeks.

Additionally, where your fissure is located will provide important clues for your doctor. Fissures that are on a side of your anal opening are more likely to be a result of an underlying condition like Crohn’s disease. If your doctor finds this is the case for you, they may order additional testing. They can perform a number of endoscopic procedures to get a closer look at the underlying issue. These procedures could include a colonoscopy, flexible sigmoidoscopy, or anoscopy, depending on other factors in your unique situation.

Treating Anal Fissures

Doctors treat anal fissures primarily by helping to make your stools softer, decreasing the pressure in the anal canal. They may recommend soaking in a warm bath (sitz bath) for 10-20 minutes per day, which can help relax your sphincter. They may also prescribe stool softeners or recommend you drink more water and eat more fiber. All of these steps can help to soften your stool and promote healing. In most cases, this can help heal an anal fissure in a few weeks.

In some cases, anal fissures can persist after these treatments. Your doctor may prescribe a topical muscle relaxant, nitroglycerin (to relax the sphincter), or other medicine to help with pain. In some cases, you may need surgery to fix an anal fissure. This is usually the case only if your symptoms are severe and chronic, and have not responded to other treatment. Surgery involves cutting a small part of the sphincter muscle to reduce spasms and promote healing. It’s very effective, but does carry a small risk of causing incontinence.

Our experienced team at GHP has years of experience treating patients with conditions including anal fissures. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.