Stress in Primary Biliary Cholangitis

We’ve all heard it before; “don’t stress over the small stuff”, “stop and smell the roses”, “don’t worry about what you can’t control”. But what does it really mean when someone with a chronic illness like PBC is told to reduce stress?

Stress is defined as a state of mental or emotional strain or tension resulting from adverse or very demanding circumstances. It can also be defined as tension exerted on a material object such as pressure or strain causing compression or twisting of another body.

According to the American Psychologic Association, there are three common types of stress: Acute, Episodic Acute, and Chronic.

Acute stress is what each of us experience every day. For example, hosting a party; meeting someone for the first time; running late for work; or bumping up against a deadline to get a project completed.

Episodic Acute stress is caused by the same every day events as acute stress but much for frequently. For example, always running late; procrastinating on all work and projects; or frequently taking on too much at once.

Chronic stress is brought on by demands and pressure that are long-term and indefinite. For example, financial stress; unhealthy relationships; or working in an undesirable job. This type of stress will wear on a person over time, and can lead to physical distress.

Everyone experiences stress at one time or another. But for those of us with an autoimmune disease like PBC, stress can wreak havoc on our already distressed system. Below are a few things we can do daily to reduce stress:

Make a plan: Getting organized and having a daily or weekly plan will help you avoid procrastinating, time crunches, and taking on too much. Sticking to your plan will give you a sense of control over your to do list. Keep in mind that it’s okay if you don’t get to something on a particular day—simply move it over to the list for the next day. Once you are comfortable with day to day task planning, look for ways to organize and plan financially. If you’re stuck in a job you dislike, make a plan to search for your dream job. Not in a good relationship? Make a plan for making it better or moving on.

Eat a nutritious diet: PBC affects the small ducts in the liver and is caused by inflammation and a build up of bile. So, continuing to eat a diet of high fat, processed, and sugary foods will only continue to cause inflammation—not only in the liver, but throughout the body. A well balanced diet of fruits, vegetables, healthy carbohydrates, and lean protein can help reduce inflammation and fat in the liver. It’s also important to stay hydrated. Drink at least eight 8 ounce glasses of water a day.

Get enough sleep: With PBC, sleep can be tricky. Research shows we should get 7-8 hours of sleep a night, but you’re exhausted during the day and when you lay down to sleep you’re wide awake. Or, you fall asleep quickly, but can’t stay asleep. Some small things that may help; have a consistent bed time and awake time, keep the temperature in your room slightly colder than is comfortable, and avoid taking hot showers before bed time as these may increase itching. If you are still unable to sleep after making these small changes, check with your doctor. He may consider prescribing something to help.

Exercise regularly: The symptoms of a chronic illness, such as PBC, can cause sadness and depression. According to a recent article published by Harvard Medical School, exercise is an all-natural treatment to fight depression – Harvard Health shows that exercise is just as effective as taking antidepressants. In addition to protecting against other illnesses such as heart disease and diabetes, exercise can increase endorphins and supports nerve cell growth in the hippocampus, improving nerve cell connections. This can help relieve depression. Keep in mind that you don’t have to run a marathon. A walk to the mailbox and back is sometimes all you need.

Take your medication as prescribed: There are two medications currently prescribed for PBC:

(1) Ursodeoxycholic Acid (UDCA/Urso) is a bile acid used to assist the flow of bile and help prevent additional scarring of the bile ducts.

(2) Obeticholic Acid (Ocaliva) is the first treatment approved for PBC in 20 years. It is taken along with Urso for PBC patients who have become less or non-responsive to Urso. It is also prescribed for patients who are unable to tolerate Urso.

There is a lot of information about supplements and what works for inflammation, liver health, sleep, etc. I caution you to not take any supplements without checking with your doctor first. While supplements may seem to work for some, they may not be appropriate for you.

In the same way PBC affects everyone differently and at different stages, everyone experiences stress differently. It’s very difficult to go from asymptomatic to symptomatic and not worry about disease progression. Thoughts of what could happen or what you should be doing can be overwhelming. Keep in mind that there is no correlation between symptoms and disease progression, so instead of getting too caught up in the anxiety of the unknown, I remind myself that PBC is a slow progressing disease and recent research shows that my chances of requiring a liver transplant are very low (less than 10% of PBC patients will require a liver transplant). I’m also optimistic that research is being done and new medication trials are ongoing. I won’t let PBC define me and I won’t give up hope that one day we’ll have a cause and a cure.

About the Author: Leslie Stratta is a Human Resources professional with a passion for health, nutrition, and fitness.  Leslie’s passion for health and fitness began while working in the Healthcare industry, but it wasn’t until 2007 when she was diagnosed with Primary Biliary Cholangitis that she began to focus on the effects of good nutrition and regular exercise as it related to managing her PBC.  As she learned about her body’s response to eating well and exercising, her passion grew into grew into a desire to coach and support others (especially those with PBC) in setting and achieving goals.

Leslie coaches her clients through various aspects of their lives including personal awareness, relationships, crucial conversations, and goal setting. Throughout all of her work, Leslie focuses on building strengths and recognizing limitations through feedback, self-discovery, and detailed action plans. She brings her experience in transitioning her own life and overcoming personal obstacles to help clients shift from merely existing to living exceptional lives.

Leslie holds a Bachelor of Business Administration in Office Administration from Sam Houston State University and a Master of Arts in Human Resource Development and Leadership from the University of Texas at Austin. Leslie’s personal and professional philosophies are the same: investing in people and developing talent will cultivate a passion for motivation, engagement, and satisfaction in career and life.

Leslie is a native of Bryan/College Station and currently lives in Houston where you will find her volunteering in her community, riding bikes, working out, and practicing aerial yoga and meditation. Leslie also volunteers in various leadership roles with the American Heart Association, Houston Livestock Show and Rodeo, and Houston Sports Authority.


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