Dear Dr. Donohue,

I am the 45-year-old mother of five children. About a year ago, I started itching. The itch moved around, but most of the time the palms of my hands were the worst. I saw a number of doctors and was given a number of medicines, but none worked. More recently, I noticed the whites of my eyes had a yellow tinge, and I went to my family doctor, who sent me to a gastroenterologist. After many tests, he discovered I have primary biliary cirrhosis. Everyone who knows I have cirrhosis thinks I am an alcoholic; I am not.

—C.M.

Cirrhosis is a scarred and poorly functioning liver. Alcohol excess is the leading cause of cirrhosis, but it’s not the only one. Your illness isn’t well known. Alcoholism is. That’s why people with cirrhosis are unjustly convicted in many people’s minds as being alcoholics.

In this condition, ducts that drain bile from the liver have closed down. Bilirubin, a pigment coming from worn-out red blood cells, is processed by the liver. When the liver no longer functions well, bilirubin blood levels rise. The whites of the eyes turn yellow. Lightly pigmented people’s skin turns yellow. Itching can be fierce, and the palms and soles often itch the most. Fats aren’t digested, and that results in diarrhea and an inability to absorb fat-soluble vitamins, like vitamin D. You have to make sure you’re getting enough of that vitamin.

What causes all this trouble? Like so many other illnesses, it comes from an immune system’s misplaced attack on a body organ — in this case, the liver.

Actigall can often lessen the intensity of some symptom. If circumstances dictate, a liver transplantation is the ultimate treatment.