Managing cognitive symptoms and fatigue in cholestatic liver disease

Introduction: Patients with cholestatic diseases may develop fatigue and cognitive symptoms. The impact of symptom burden may be significant in some patients. To date, there are no effective pharmacological therapies to improve cognitive symptoms or fatigue in cholestasis and we are wholly reliant on supportive approaches. Area covered: This review provides an overview of cognitive symptoms and fatigue in the cholestatic liver disease primary biliary cholangitis (PBC), including pathophysiology and our approach to the management of these symptoms. Expert opinion: The impact of fatigue and cognitive symptoms on the perceived quality of life can be profound for patients with PBC. The pathophysiology of these symptoms is complex and poorly understood, making the development of therapeutic trials of symptom-directed therapies challenging. The current recommended management for fatigue and cognitive symptoms is mainly supportive.

Automated summary

Patients with cholestatic diseases, especially primary biliary cholangitis (PBC), may experience significant fatigue and cognitive symptoms. Despite the lack of effective pharmacological therapies, supportive approaches remain the mainstay of management for these symptoms. The impact of fatigue and cognitive symptoms on quality of life in PBC patients is profound, highlighting the need for further research and development of targeted therapies.