Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Seek emergency help for:
Vomiting blood or material that looks like coffee grounds
Black, tar-like stools
Sudden confusion, unusual drowsiness or difficulty waking
Fainting, severe weakness or breathing difficulty
Rapidly increasing abdominal swelling with severe pain
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
If you already have PBC, contact your healthcare team promptly for new jaundice, increasing abdominal swelling, leg swelling, unexplained weight loss or a clear change in symptoms.
Fever with worsening upper abdominal pain also needs urgent assessment.
These can be signs of bleeding, infection or advanced liver complications and should not wait for a routine appointment.
3
Does any of this apply?
Book an appointment
Arrange a routine medical appointment if you develop persistent unexplained itching, fatigue, dry eyes or dry mouth, or if blood tests repeatedly show a raised ALP.
These symptoms have many possible causes and do not by themselves mean you have PBC.
Every sign above is quoted from the sofidex article on Primary biliary cholangitis. If you are not sure, err upward — it is always reasonable to be checked.