myPBC
Symptom Check-In Report — Past 2 Weeks
Symptom Check-In
Help your care team understand how you've been feeling. Complete as many sections as apply to you — your answers will be shared with your hepatologist.
👤 Patient Details Optional
My PBC
Medications & lab values
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Treatment Record
Second-line therapies
Elafibranor
Seladelpar
Fenofibrate
Obeticholic Acid
Itch (Pruritus)
Skin itching in the past 2 weeks
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Symptom
Have you experienced itching?
Average severity of itch
Has itching disturbed your sleep?
Have you noticed dry skin?
Treatments used
Fatigue
Energy levels & sleep quality
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Symptom
Have you felt unusually tired or fatigued?
Do you wake up feeling unrefreshed or already fatigued?
If yes, which apply to you?
Do you use a phone, tablet, or watch TV within 2 hours before bed?
Do you run out of energy by the afternoon?
Do you need to nap during the day?
Treatments used
Dry Eyes
Dryness or gritty sensation
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Symptom
Have you had dry or gritty eyes?
How often has this bothered you?
Treatments used
Dry Mouth
Dryness or discomfort
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Symptom
Have you had a dry mouth?
How often has this bothered you?
Treatments used
Bone or Joint Pain
Aching, stiffness or discomfort
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Symptom
Have you had bone or joint pain?
How often has this bothered you?
Abdominal Pain
Right upper abdomen pain or discomfort
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Symptom
Have you had pain or discomfort in the right upper side of your abdomen?
How often has this bothered you?
Mood & Mental Wellbeing
Depression, anxiety & support
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Wellbeing
Have you felt low, anxious, or emotionally struggled in the past 2 weeks?
Support / treatments used
Additional Notes Optional
Anything else you'd like your doctor to know
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