How is biliary cirrhosis treated?

The main cause of biliary cirrhosis is obstruction of the bile duct and bile stasis leading to bile duct closure, forming the disease. Its main symptoms are enlarged liver, spleen, kidneys, and skin lesions, which have a great impact on body shape and can even lead to death in severe cases. The following is its treatment guideline.

[Treatment policy]

The disease is mainly treated with drugs such as ursodeoxycholic acid, D-penicillamine, and immunosuppressants. Liver transplantation is an option for patients with end-stage primary biliary cirrhosis.

[Drug treatment]

1. Ursodeoxycholic acid:

Ursodeoxycholic acid can improve the serum markers of cholestasis. Within 3 months, serum bilirubin can be significantly reduced, and serum alkaline phosphatase, transaminase, cholesterol and IgM can also be significantly reduced.

2.D-Penicillamine:

It can reduce copper levels in the liver, inhibit inflammatory responses, reduce fibrosis, and prolong patient survival. Serious adverse reactions include rash, proteinuria, thrombocytopenia or granulocytopenia. Urine protein should be checked weekly and once a month after 4 weeks to observe changes in white blood cell count. Treatment should be discontinued if necessary.

3. Immunosuppressive drugs:

① Cyclosporine A has obvious effects, but it should not be used for a long time due to its liver and kidney toxicity. After 8 weeks of treatment, serum alkaline phosphatase decreased significantly. ②Methotrexate: early application of small doses can improve histological changes.

③Azathioprine can improve the excretion of the bile duct and seems to be effective for skin itching, but it has large side effects and cannot prevent liver cell failure.

4. Symptomatic treatment

(1) Itching: Antihistamines such as phenergan, chlorpheniramine, diphenhydramine, etc. can be used. Cholestyramine: start with a small dose until the itching is controlled. Aluminum hydroxide can bind to bile acids and is effective for hepatic pruritus.

(2) Osteoporosis and ossification: Vitamin D can be injected intramuscularly. Calcium gluconate is diluted in glucose solution and administered intravenously.

(3) Night blindness: Vitamin A. If serum zinc is lower than normal, zinc sulfate can be taken orally for 4 weeks until dark adaptation returns to normal.

(4) People with coagulation disorders can use vitamin K1.

[Prognosis]

The prognosis is related to serum total bilirubin, albumin, age, prothrombin time and degree of edema, and symptoms can be improved after treatment.