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Primary Biliary Cirrhosis Doctor - Dr. Scott Liu

Primary biliary cirrhosis (PBC) is a chronic hepatitis that affects the bile ducts causing build up of bile and scarring. Dr. Scott is a specialist in diagnosing, creating personalized treatment programs and care to prevent the progress of diseases and preserve your liver at GastroDoxs in Houston.

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Scott Liu

About the Expert

Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.

What Is Primary Biliary Cirrhosis?

Primary biliary cirrhosis (PBC) is an autoimmune, chronic liver disease that presents slowly over time as the immune system of the body repeatedly destroys the small bile ducts internally in the liver. By getting inflamed and scarred, the ducts are unable to flow in their usual manner that results in the build-up of bile, cell damage in the liver and subsequent fibrosis. Disease progression and preservation of liver function can be slowed, and this can be obtained through early recognition and treatment.

Common Causes and Risk Factors

  • Autoimmune attack on the small intrahepatic bile ducts
  • Female gender, most often between ages 40 and 60
  • Family history of PBC or other autoimmune diseases
  • Coexisting autoimmune conditions (e.g., Hashimoto's thyroiditis, rheumatoid arthritis, Sjögren's syndrome)
  • Genetic predisposition or certain HLA gene variants

Signs and Symptoms

  • Fatigue or persistent tiredness
  • Itchy skin (pruritus), often worse at night
  • Dry eyes and/or dry mouth (sicca symptoms)
  • Jaundice (yellowing of the skin and eyes)
  • Discomfort or fullness under the right rib cage

How Dr. Scott Diagnoses Primary Biliary Cirrhosis (PBC)

Dr. Scott uses a step-by-step approach:

Medical History and Exam

He examines the history of your general health and of risk factors, and then asks specific questions about your pain in the epigastriel its timing, whether related to meals or not, and whether it has any associated symptoms, and makes a focused abdominal examination.

Blood Tests

To diagnose PBC, we test liver enzymes (ALP, ALT, AST), bilirubin levels and antimitochondrial antibodies (AMA). We can also test H. pylori in case epigastric discomfort has indicated that the patient has ulcer disease.

Imaging Studies

  • Abdominal ultrasound checks liver size, bile ducts, gallbladder, and looks for stones or duct dilation.
  • MRCP (magnetic resonance cholangiopancreatography) gives detailed views of the biliary tree and pancreas to spot strictures or blockages.

Endoscopy and ERCP (if needed)

An upper endoscopy also uses an examination of the stomach and duodenum with ulcers or gastritis which are the causes of stomach pain. ERCP is able to treat and visualize constricted bile ducts in PBC.

Liver Biopsy (if needed)

In noninvasive tests that are inconclusive, a liver biopsy is done to establish PBC and evaluate any inflammation and scarring.

Dr. Scott
Treatment

Our Team offers a full range of care for primary biliary cirrhosis.

1. Lifestyle and Dietary Changes.

  • High intake of fruits, vegetables, lean proteins and whole grains to maintain the function of the liver.
  • Further bile duct injury prevention through alcohol avoidance.
  • Individualized exercise/stress-management regimen, which involves walking and yoga and relaxation.

2. Medications

  • Ursodeoxycholic acid to enhance bile passage and slacken the disease.
  • Obeticholic acid if the patient requires extra support of the bile-duct.
  • Symptom-orientated treatment to reduce itching and replace deficiencies of vitamins.

3. Minimum Invasive or Advanced Surgery.

  • Endoscopic Retrograde Cholangiopancreatography (ERCP) to open obstructed bile ducts.
  • The liver biopsy to accurately determine inflammation and scarring.
  • Preparation and assessment of liver transplantation at the advanced stage.
Scott Liu

About the Expert

Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.

Frequently Asked Questions

What does primary biliary cirrhosis mean?

Primary biliary cirrhosis (PBC) is a long-lasting liver disease whereby small bile ducts are inflamed and destroyed resulting in bile that accumulates filling the liver leading to scarring.

What is the etiology of primary biliary cirrhosis?

It is believed that PBC is an autoimmune disease in which the immunity of the human body attacks its bile ducts.

What are the symptoms to observe?

Some of the early symptoms are permanent exhaustion, itchy skin (particularly at night), dry mouth or eyes, jaundice (yellow color of the skin or eyes) and pain in the right-side ribs.

How is PBC diagnosed?

Liver enzyme and antimitochondrial antibody blood tests, ultrasound or MRI imaging, and liver biopsy are sometimes carried out to diagnose it.

Which are the treatment options?

It can be treated with ursodeoxycholic acid or obeticholic acid to enhance bile flow, symptomatic medication, changes in lifestyle, ERCP to ductal obstruction, and liver transplant in severe instances.

Is diet and exercise beneficial in the treatment of PBC?

Yes. It helps the liver to be healthy by eating a balanced diet of fruits, vegetables, lean proteins, whole grain, frequent mild exercises, and not drinking alcohol.

In which cases do I recommend I see a liver specialist in Houston?

In case you feel unusual fatigue, chronic itching, or abnormal liver test results, or any other symptoms that may indicate PBC, use an appointment with a hepatologist as soon as possible.

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