Itching and fatigue, years before anything else.
Primary biliary cholangitis is an autoimmune condition in which the small bile ducts inside the liver are gradually destroyed. It affects women far more often than men, usually appears in middle age, and often announces itself as persistent itching and fatigue long before liver tests are dramatic. Diagnosis is by antimitochondrial antibodies and cholestatic liver enzymes.
Worth answering if you have had unexplained itching or fatigue for months, or a family history of autoimmune liver disease.
- Itching without a rash, often worse at night
- Fatigue out of proportion to everything else
- Dry eyes and a dry mouth
- A dull discomfort under the right ribs
- Liver enzymes reported as mildly abnormal, sometimes for years
Itching without a rash that has lasted months deserves a liver panel regardless of what this questionnaire says.
Three steps, in the order a clinician takes them.
- 1
It is often found in a blood test before it is suspected
A cholestatic pattern of liver enzymes — a raised alkaline phosphatase in particular — is frequently the first sign, picked up incidentally. Itching and fatigue can precede it by years.
- 2
Antibodies confirm it
Antimitochondrial antibodies are present in the large majority of cases. A raised alkaline phosphatase with those antibodies is usually enough for the diagnosis without a biopsy.
- 3
Then staging, and treatment that works better started early
Imaging and non-invasive fibrosis assessment establish the stage. Treatment slows progression, and starting it earlier matters — which is the argument for chasing months of unexplained itching rather than waiting.
You walk away with a page you can hand over.
Under a minute. It asks about your history only, scores it the way the source document scores it, and gives you the answers back as something worth mentioning, worth bringing and worth asking — in a file you can download. It is not a diagnosis, and it does not predict anything.
Take the questionnaire- How long the itching or fatigue has been going on, in months or years
- Any liver blood test you have had, even one you were told was borderline
- Other autoimmune conditions, particularly thyroid disease or Sjögren syndrome
- Family history of autoimmune liver or thyroid disease
The primary biliary cholangitis questionnaire
Five questions about liver history and the symptoms this condition tends to bring. It is uncommon, and it is diagnosed on blood tests and imaging rather than on symptoms.
- 5questions
- Under a minute.to finish
- Nothing savedanswers stay in this tab
This is the questionnaire domain of ONU’s own model, not a diagnosis and not a probability. Primary biliary cholangitis is confirmed by specific antibody and liver blood tests, not by a set of questions.
Straight answers, including the awkward ones.
What is the difference between PBC and primary sclerosing cholangitis?
Both damage bile ducts, but PBC affects the small ducts inside the liver, is autoimmune, mostly affects women in middle age, and is identified by antimitochondrial antibodies. Primary sclerosing cholangitis affects the larger ducts, is more common in men, and is strongly associated with inflammatory bowel disease. They are diagnosed and managed differently.
Why does itching come before anything else?
Substances normally cleared in bile accumulate when the small ducts are damaged, and they provoke itching well before the liver is failing at anything. That is why months of unexplained itching without a rash deserves a liver panel, even when you otherwise feel fine.
Is PBC still called primary biliary cirrhosis?
No. It was renamed primary biliary cholangitis, because most people diagnosed with it never develop cirrhosis — particularly when treatment starts early. The old name caused unnecessary fear.
Can this questionnaire diagnose it?
No. PBC is diagnosed with antimitochondrial antibodies and a cholestatic liver enzyme pattern, and no questionnaire substitutes for those. Five history questions cannot do it, and this page says so rather than implying otherwise.
One domain of a larger model.
This is one of four domains. The others — thirteen blood markers, an age term and a sex term — need laboratory results a clinician interprets, so the full score cannot be produced here.
Questionnaire source: Primary Biliary Cholangitis risk model.docx — questionnaire domain
Independent health information: NHS: Primary biliary cholangitis. This source explains the condition; it does not validate the questionnaire as a diagnostic test.
Thyroid
Thyroid problems are common, easy to test for, and easy to miss — because the symptoms look like ordinary life.
Read the area
Ascites
Worth answering if your abdomen has been swelling, if you have a known liver condition, or if you are preparing for an appointment about either.
Open the check
Jaundice
Worth answering if you or someone you look after has noticed yellowing, dark urine or pale stools, and wants to arrive at an appointment with the history already straight.
Open the check
Crohn’s disease
Worth answering if you have had months of abdominal pain, diarrhoea, weight loss or fatigue and are trying to describe it accurately to a clinician.
Open the checkA questionnaire is a snapshot. A night is not.
This was your history, written down once. The bracelet is the part that keeps watching — sleep, resting heart rate, temperature and movement, night after night, in one place.
