Testing for Liver Fibrosis (Scarring)
Understanding Liver Fibrosis Staging:
Liver fibrosis is a condition where scar tissue forms in the liver due to chronic liver injury. Staging fibrosis helps doctors understand the severity and progression of the disease. Here are some common methods used to stage liver fibrosis:
Blood Tests: Your doctor may perform blood tests to check for liver enzymes like ALT and AST, as well as other markers like platelet count and bilirubin levels. These tests give an overall picture of liver health and can indicate the presence of fibrosis. There are several specific scoring systems like the Fibrosis-4 (FIB-4) index or the AST to Platelet Ratio Index (APRI) that use blood test results to estimate the degree of fibrosis. Links at the bottom of this page include commonly used 'calculators' that doctors use to predict if you have liver fibrosis.
Transient Elastography (FibroScan): This is a non-invasive test where a special ultrasound probe is used to measure liver stiffness. Higher stiffness indicates more fibrosis. It's quick and painless, providing immediate results. Links at the bottom of this page explain this type of testing.
Imaging Tests: Imaging techniques such as ultrasound, MRI, or CT scans can help visualize the liver and detect signs of fibrosis. These tests are non-invasive and provide valuable information about the liver's condition but are not always reliable.
Liver Biopsy: In some cases, a liver biopsy may be recommended. During this procedure, a small sample of liver tissue is taken and examined under a microscope to assess the extent of fibrosis. While more invasive, it can provide detailed information about the liver's condition.
Treatment and Management:
Once fibrosis is staged, your doctor should discuss treatment options tailored to your condition. These may include lifestyle changes like a healthy diet, exercise, and avoiding alcohol. Medications may be prescribed to manage underlying liver diseases. Regular monitoring through follow-up tests will help track the progression of fibrosis and adjust treatment as needed.
It's essential to communicate openly with your healthcare team, follow their recommendations, and attend regular check-ups to keep your liver as healthy as possible.
The link above allows you to enter your age and several labs (AST, ALT, platelet count) to calculate your "FIB-4" score, a test that can be used to predict if you may have significant underlying scarring in the liver. While not perfect, a low value can be reassuring and argue against doing additional testing, and a high value should warrant further testing.
This video gives a brief overview of transient elastography (also called fibroscan), including how the test is performed.
This video provides an overview of what a liver biopsy is, what the risks are, and what to expect on the day of your procedure.