Living with primary biliary cholangitis (PBC) can affect how you think about food. Some people may deal with low appetite, nausea, or digestive symptoms that make eating more complicated. Others may simply wonder whether changing what they eat could help them feel their best.

In conversations on myPBCteam like “In What Ways Has PBC Changed Your Eating Habits?” members have shared their approaches to food. Some have changed portion sizes or cut back on certain foods. Others focus on Mediterranean-style eating or pay closer attention to sodium. And some haven’t needed to change their diet at all.

There isn’t one PBC diet that works for everyone. Before making major changes to your diet, talk with your healthcare team about what’s right for you.

Here are six tips and experiences myPBCteam members have shared.

A low appetite or nausea can make a full meal feel overwhelming. Some myPBCteam members said smaller portions are easier for them to manage, and smaller, more frequent meals may also feel easier on difficult days.

One member kept their approach simple: “Smaller portions for sure. Less fat and salt.”

Another member living with cirrhosis (severe scarring of the liver) described eating small meals throughout the day:

 

“I eat small meals during the day (I have cirrhosis). I drink lots of water.”

 

— A myPBCteam member

If nausea, poor appetite, or other digestive symptoms are making it hard to eat enough, tell your healthcare provider. They can help identify what may be causing your symptoms and whether you need extra nutritional support.

For some people with PBC, especially those with fluid buildup, a doctor may recommend a reduced-sodium diet.

For some, cutting back on salt can be difficult. “Salt has been the hardest to cut out,” a member shared.

Another member found a flavorful way to adapt:

 

“Sodium has been the most challenging, but I’ve gotten good at using herbs and lemon on everything.”

 

— A myPBCteam member

Dietary needs can vary depending on your health, including whether you have complications related to PBC. If your healthcare provider recommends limiting sodium, ask what amount is right for you. A registered dietitian or other health professional may also be able to suggest ways to make lower-sodium meals enjoyable.

Some members said they have reduced their intake of fried foods, fatty foods, or red meat. For some, the decision came down to how they felt after eating these foods.

One member described experiencing digestive discomfort:

 

“I can’t process red meat or fried foods well at all; I get indigestion. I try to limit and avoid all together fatty foods.”

 

— A myPBCteam member

These experiences don’t mean everyone with PBC needs to avoid red meat, fried foods, or all fats. But some people with PBC, particularly those with more advanced disease, may have trouble absorbing fats. This can contribute to diarrhea and other digestive symptoms.

If certain foods consistently bother you, track them and discuss the pattern with your healthcare team before cutting out entire food groups.

Some myPBCteam members said they focus on fruits, vegetables, whole grains, and sources of protein such as fish, chicken, and eggs. Others described their approach as Mediterranean-style eating, an approach the American Liver Foundation says is often modified for individual needs.

One member explained,

 

“The Mediterranean diet has been my go-to. Not much of a meat eater but do get in my protein with fish, chicken, eggs.”

 

— A myPBCteam member

Another myPBCteam member takes a similar approach: “I focus on eating fish/chicken, veggies, and fruit for protein and energy.”

Other members also compare notes on foods that may help support energy levels with PBC.

Instead of following someone else’s diet exactly, talk with your healthcare team about what foods and meals may work best for you. This may be especially important if symptoms are limiting what or how much you can eat.

Food isn’t the only part of a diet that members reconsider after a PBC diagnosis. Some people also described drinking more water to stay hydrated or changing their usual beverages.

One myPBCteam member said, “I am drinking much more water now than I previously did. Also trying to limit my diet sodas.”

Another member shared, “I don’t drink any sugary soft drinks, iced teas, or coffees.”

Members also mentioned eliminating alcohol, but individual decisions about beverages shouldn’t be taken as medical advice for everyone with PBC. However, health experts advise people with PBC to avoid or limit alcohol. People with PBC who have cirrhosis should avoid alcohol completely.

Talk with your healthcare provider about alcohol and other drinks in the context of your liver health, medications, and overall care plan.

Perhaps one of the clearest themes among myPBCteam members is that there’s no single way of eating that fits everyone. Foods that work well for one person may cause uncomfortable symptoms for someone else.

One member summed up that idea this way: “It’s good to eat what works for you. ❤️”

Another member said their doctor hadn’t recommended dietary changes: “My doctor indicated there was nothing to change. It wouldn’t affect my diagnosis or prognosis, so I haven’t changed anything.”

That difference is an important reminder not to assume you need a long list of food restrictions because you have PBC. If you’re thinking about eliminating a major food group, be careful, and check with a physician and registered dietitian.

Food choices with PBC can be personal. Several myPBCteam members have found different ways to make eating work for them, from smaller meals and lower-sodium cooking to choosing foods that feel easier to tolerate. Paying attention to your own experience while working with your healthcare team can help you find an approach that fits your needs.