Why is the liver disease called PBC more common in women? (Primary Biliary Cholangitis - PBC)

Have you ever heard of PBC, a liver disease? You may not be familiar with the name. But did you know that nine out of every ten people who suffer from this condition are women? That's really surprising, isn't it? So why does this disease seem to target women? What is the reason for this? Today, we will talk about this very simply, in a way that you can understand.

Let's first see, what is PBC?

Okay, this is a bit of a scientific name, but what happens is very simple. PBC, which stands for Primary Biliary Cholangitis, is a disease in which our body's own immune system goes haywire and attacks our own liver. We call such diseases autoimmune diseases. Think of it, our body's immune system is like an army that protects a country. The duty of this army is to fight germs and viruses that come from outside and save us from diseases. But sometimes this army makes a mistake and starts attacking innocent people in its own country. Something similar happens in PBC. Our own immune system attacks the small bile ducts in our liver. These bile ducts are a very important system of tubes that carry bile produced by the liver to the intestines. When these ducts are damaged, bile does not flow properly and accumulates inside the liver, gradually damaging the liver.

So why does this affect women more?

Now let's look at the answer to the biggest question everyone has. Researchers still haven't found a single, definitive cause for this. However, they believe that three main factors contribute to it.

1. The influence of hormones

You know, women's bodies are very different from men's bodies. The main reason for that is hormones. In particular, the hormone estrogen plays a very important role in every stage of a woman's life. Think about it, with the monthly menstrual cycle, and especially with menopause, which occurs between the ages of 40-60, there are big changes in the levels of this estrogen hormone. These hormonal changes directly affect the way the cells of our immune system function. The estrogen hormone can stimulate the immune system too much. That is, activate the "army" we talked about earlier too much. When this happens, the risk of attacking its own cells increases. We can imagine this connection since PBC is most common among women in this age group.

2. Bacteria in the intestines

This may be a little new to you. Trillions of good and bad bacteria live in our guts. This community of bacteria is very important for our health. Research has found that people who carry a genetic predisposition to developing PBC have different types of bacteria in their guts than others. They also have higher levels of a type of bacteria that is commonly associated with urinary tract infections (UTIs). So this suggests that certain bacterial infections and imbalances in gut bacteria may be contributing to the development of PBC by disrupting the immune system.

3. The influence of genes and heredity

"Is this a hereditary disease?" you may be wondering. Yes, to some extent, genes do play a role.

• Between 1% and 9% of people with PBC have another family member with the disease.
• If one of two identical twins develops PBC, there is a 63% chance that the other will also develop it.

More important than all of this is the involvement of the X chromosome . Simply put, women have two X chromosomes (XX), while men have one X chromosome and one Y chromosome (XY). Research has shown that women with PBC have one X chromosome missing or have certain changes in the X chromosome in some cells of their bodies. These changes may affect the function of genes involved in the immune system, increasing the risk of developing this autoimmune disease.

Is it possible to live well with PBC?

Absolutely yes! PBC is a disease that can be well controlled with proper medical treatment and lifestyle changes. The earlier the disease is detected, the easier it is to control the damage to the liver. The most important thing when living with this disease is to maintain a constant relationship with your doctor . It is essential to take the medication he prescribes on time, attend the clinics on time. In addition, by eating a balanced diet, completely avoiding alcohol, and engaging in appropriate exercise as advised by your doctor, you can live a healthy life. There are now very good treatments to control the symptoms of the disease, such as excessive fatigue and itchy skin. So talk openly with your doctor about it. PBC, Primary Biliary Cholangitis, Liver Disease, Women's Health, Autoimmune Diseases, Estrogen, Hormones, Genes, Liver Disease in Women Sinhala, akmawe leda