Fatigue is common among people with primary biliary cholangitis (PBC) and can seriously affect quality of life, according to a recent review in The Lancet Gastroenterology & Hepatology.
The review found that fatigue affects about two-thirds (63%) of people with PBC, regardless of how advanced their liver disease is or how well they respond to treatment. This is not the usual kind of tiredness that improves after rest or sleep. Instead, PBC fatigue feels like a lack of energy or exhaustion that is out of proportion to how much activity a person has done and that doesn’t go away, even with plenty of rest.
According to the researchers, this kind of fatigue can significantly affect quality of life — not just physically, but also emotionally and mentally.
“Despite its burden, the awareness of fatigue in PBC among treating physicians is low,” the review’s authors said.
They developed a practical “ASK–MEASURE–TREAT” method to help doctors assess and manage fatigue in PBC. This involves asking patients about fatigue, measuring its severity and treating underlying conditions such as sleep or mood problems.
Read more about PBC signs and symptoms
Doctors still don’t understand the exact cause of PBC, but they believe it results from a combination of different factors, including itching (pruritus), depression or low mood, daytime sleepiness and autonomic dysfunction — a problem with the body’s automatic functions such as blood pressure, heart rate and digestion.
No medication has yet been proven to reduce fatigue. Some research suggests that bezafibrate, setanaxib, seladelpar and elafibranor may have potential beneficial effects on fatigue, but more research is needed.
Early research suggests that nondrug options like exercise programs, online body-mind programs and bright light therapy may help.
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