According to a study recently published in Gastroenterology Insights, patients with primary biliary cholangitis (PBC) are at an increased risk of developing esophageal varices — swollen veins in the esophagus — and colon polyps, noncancerous growths in the large intestine. These findings indicate that patients with PBC may benefit from monitoring with endoscopic examinations, such as colonoscopies or upper endoscopies.
PBC can lead to severe liver scaring, called cirrhosis. It’s usually recommended that patients with cirrhosis have endoscopic examinations due to their increased risk of developing esophageal varices and portal hypertension (high blood pressure in the portal vein). However, patients with PBC do not routinely undergo this screening.
Researchers sought to investigate if there are grounds for which patients with PBC should undergo more endoscopic examinations. They hence reviewed data from patients with PBC seen at a hospital in Taiwan over a 19-year period. In addition, a control group with a similar sex ratio was recruited. Each individual underwent endoscopic assessments. In total, 28 patients with PBC underwent endoscopic assessments, while 114 in the control group did.
Read more about PBC testing and diagnosis
Almost half of the patients with PBC were found to have esophageal varices, while none of the patients in the control group did.
In addition, patients with PBC had a higher risk of developing colon polyps compared with the control group: 50% of patients with PBC had colon polyps, compared to only 14% of those without PBC.
There are reasons to monitor both esophageal varices and colon polyps. Esophageal varices can cause severe, life-threatening bleeding if they rupture. Colon polyps may cause a change in bowel habits, such as constipation or diarrhea, as well as abdominal pain; additionally, some research indicates that colon polyps may increase the risk of colon cancer in those with PBC.
“The findings regarding the higher risks of esophageal varices and colon polyps support the rationale for endoscopic examination in PBC patients,” the study’s authors wrote. However, they also cautioned that the small sample size in this study means that further studies are needed to confirm these findings.
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