Cirrhosis - Diagnosing cirrhosis
- Introduction
- Symptoms of cirrhosis
- Causes of cirrhosis
- Diagnosing cirrhosis
- Treating cirrhosis
- Preventing cirrhosis
- 'I haven't touched a drop for three years now'
If your GP suspects cirrhosis, they will check your medical history and carry out a physical examination to look for signs of chronic liver disease.
If they suspect you have a damaged liver, you'll be referred for tests to confirm the diagnosis.
Tests
You may have any of the tests described below:
- Blood tests - to measure your liver function and the amount of liver damage. The test may measure the levels of the liver enzymes alanine transaminase (ALT) and aspartate transferase (AST) in your blood, as these will be raised if you have inflammation of the liver (hepatitis).
- Scans – an ultrasound scan, transient elastography (a similar test to an ultrasound scan carried out during pregnancy; it is sometimes referred to as Fibroscan), computerised tomography (CT) scan or a magnetic resonance imaging (MRI) scan may be carried out on your liver. These scans can produce detailed images of your liver or check liver stiffness to identify any scarring.
- Liver biopsy – where a fine needle is inserted into your body (usually between your ribs), in order to remove a small sample of liver cells. The sample is then sent to a laboratory to be examined under a microscope. The biopsy is usually carried out under local anaesthetic, as a day case or with an overnight stay in hospital. The outcome of the biopsy will confirm a diagnosis of cirrhosis and may provide more information about the cause. However, transient elastography is increasingly being used as an alternative to a biopsy in the diagnosis of cirrhosis.
- Endoscopy – an endoscope is a thin, long, flexible tube with a light and a video camera at one end. It is passed down your oesophagus (the long tube that carries food from the throat to the stomach) and into your stomach. Images of your oesophagus and stomach are transmitted to an external screen where any varices (swollen vessels) a sign of cirrhosis, can be seen.
The Lab Tests Online website has more information about ALT and AST measurements.
Grading
There are several different systems for grading cirrhosis according to how serious it is. One system is the Child-Pugh score which, based on your examination and laboratory tests, grades cirrhosis from A (relatively mild) to C (severe).
An alternative system called model of end-stage liver disease (MELD) uses the results of a blood test to help identify people who need an urgent liver transplant.
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