Brief Answer:
Please attached the asked details.

Detailed Answer:
Hello Dear,
Thanks for asking your query on this forum.
Have gone through your history and i appreciate your concern.

Firstly i would ask you to elaborate "borthersome" please explain all your symptoms vividlty which you mean by bothersome.

However i would pen down some of the signs which you should look on as they are indicator of worsening of problems-

1)Pain in the upper right portion of the abdomen.
2)Bone, muscle or joint (musculoskeletal) pain.
3)Yellowing of the skin and eyes (jaundice).
4()Darkening of the skin that's not related to sun exposure (hyperpigmentation).
5)Swollen feet and ankles (edema).
6)Buildup of fluid in the abdomen due to liver failure (ascites).
7)Fatty deposits on the skin around your eyes, your eyelids, or in the creases in your palms, soles, elbows or knees (xanthomas).
8)Weak and brittle bones (osteoporosis), which can lead to fractures.
9)(Elevated cholesterol.
10)Diarrhea that can be greasy (steatorrhea).

Please mention with your follow ups how many signs are there in you.

I know that your blood work out was normal,but please tell me in details the intensity of above mentioned symptoms earlier and now.
A good professional advice can only be given after that only.

Waiting for your detailed follow up.

Regards.

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Brief Answer:
Folow up advice.

Detailed Answer:
Hello thanks for praises,
Have gone through your question.

I feel that going through mechanism will help you a lot in understanding your basic problems.
Though the origin of pruritus in cholestatic liver diseases is poorly understood. Despite numerous theories,the definite molecular pathogenesis of this phenomenon still remains unknown; however, there are plenty of views
on this subject-

Researches have shown that patients with liver problems have significantly higher number of Mast cells in their body as compared to their counterparts.Mast cell release a toxin called histamine in blood which is responsible for itching. Bile acids are known to be potent activators of
mast cells. As a result, the degranulation of mast cells induced
by bile acids and histamine’s excretion in consequence might
also constitute the reason for itch.
XXXXXXX and Love says"Pruritus touches nearly 70% of PBC patients. Once
itching occurs in a person with this illness, it is unusual
for it do disappear spontaneously. Its perception seems to
vary among patients; itch can be intermitted or persistent,
localized to specific parts of body however it has no corelation with progression of disease"

"No correlation of intensity or incidence of
itch with the severity of cholestasis has been noted"
Love and XXXXXXX is Bible of Surgery.

Hope you got your answer in the lines ofone of the most standard text book of Medicine.

None as of now the Dr is terrific? can't understand what you want to ask in your last line.

Follow ups are welcome.

Regards.

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