Is the Fibro scan conclusive

[sunflower1]

I have possibly asked this before but due to go to the Roadshow soon.. if he Fibroscan is "normal" or indeed "abnormal" is that conclusive. If it is normal have you certainly not have liver disease and vise versa you do?

Thanks

[briccolone]

hi sunflower there are better informed people on this forum who are more qualified to answer this but if you look at what the London clinic(for example) says about it and they specialise in these tests-anything above 7 and you need to start making changes pretty rapidly to your lifestyle. I seem to recall your test as 6? I would look at diet/alcohol consumption/exercise-you know the usual format. If I manage to get one done at the roadshow I will be pleasantly surprised to see anything less than 7-sadly I suspect not! I don't think there's anything definitive though about scans.

[sunflower1 in reply to briccolone]

On the ball as always Briccolone!!! I was 6.7 last year, interesting to see what difference a year makes. Had an ultrasound a few weeks ago which was "normal" Still getting itching and as I said now pain in my feet. I did look at Gout as you suggested, not sure if it is that.. really dont know. I have yet another appointment to see another doctor, not sure I will go yet though, maybe just wait until after the roadshow.. What day is your roadshow local to you?

[briccolone in reply to sunflower1]

hi sunflower-one of the things that I learned from last years posts is that you can have symptoms but all the bloods/scans etc. look clear. I definitely had symptoms when I had my ultrasound which was clear but my ggts were raised which suggests problems with the biliary system. I had itching also-pale stools etc. which all cleared up with diet and cessation of drinking. It took me months to become asymptomatic. I was fine for a few months but some symptoms came back-guess why? drinking wine again-nothing like I was of course. Being older I've realised I just can't do what I used to do. As Bolly says-every now and then and strictly within limits-I haven't learned that yet! My question to you is-is there anything you can do to, become asymptomatic? I seem to recall that if you don't drink the itching disappears or have things changed? I seem to be on the mend..I also had problems with dry skin on the fingers (improving)which can also be a sign of liver stress. I think the london roadshow is tomorrow or tuesday-will keep you posted. In the meantime don't worry too much-All your tests so far are fine!

[sunflower1 in reply to briccolone]

Morning Briccolone,My last lot of blood tests were August but not sure if GGTs were done on that batch. I dont get the pale stools. I have cut back on the wine, is it now we are sensitive to wine? Generally (not not always) after I have had wine I start to itch the next day. Its a weird one as sometimes I dont itch at all.. not very often though. I am not drinking at the moment but still itch, mostly at night. I do get dry flaky skin on my forehead but I am not the best at drining water at all as I dont like it!! Thanks for your post.

[briccolone in reply to sunflower1]

interesting-the fact that your digestive system seems in good order plus your blood tests are normals plus ultrasound clear etc. suggests liver in good shape-I wouldn't worry too much -especially if you're not drinking much. Itching dry skin can have a number of causes-some people have already mentioned allergies to what's in wine-sulphites etc. why don't you try organic wines which have little in the way of additives-there may be some improvement-worth a try at least. could also be yeast intlolerance -candida

[CHESMER03]

I would suggest looking up a clinical guidance published by National Institute for Health and Care Excellence in June 2013, CG165, "Diagnosis and Management of Chronic hepatitis B in children, young people and adults". In the full version of the guideline, you will find a helpful account in section 8.2 detailing the "assessment of liver disease in secondary specialist care", which includes transient elastography (fibroscan). You will find on page 83 that a score of 7.2 kPa or over indicates fibrosis and 13 kPa, cirrhosis. There is also a shorter, simplified version of the guidelines for the public. Hope this helps.

[sunflower1 in reply to CHESMER03]

Thanks for your post Chermer, I have just had a brief look, What I was looking at did not go up to page 82.... this is what I could find which I thing relates to te Fibroscan...

"The degree of fibrosis cannot be accurately predicted in adults with a transient elastography score between 6 to 10 kPa. Some people may choose to have a liver biopsy in these circumstances to confirm the extent of liver disease.

[6]Adults with a transient elastography score less than 6 kPa are unlikely to have significant fibrosis.

So are they saying if your between 6-10 they dont know to what extend the Fibrosis is? Ander if you are under 6 you are "unlikey" to have Fibrosis, this all sound VERY inconclusive to me?

[CHESMER03 in reply to sunflower1]

I understand fibroscan is a technique used to assess liver stiffness without invasive investigation such as liver biopsy. It is one of the tests used by doctors in their diagnosis and monitoring of liver disease. The threshold of 7.2 kPa was agreed by the experts based on best clinical evidence available to the Clinical Guidelines Group, and supported by other experts following consultation in the wider NHS. It is a helpful tool to screen fibrosis and assess any cirrhosis, but I would not put faith in any single indicator as definitive without other information, such as blood tests, life style characteristics and family origins etc.

[briccolone in reply to CHESMER03]

very useful -thanks

[Tatjana]

Tatjana

Hi Big F I won't give you a lecture about drinking except you know it does you no good but, more importantly I have a long story to tell but suffice it to say I have a Fibroscan result of 7.5 which I understand is good, my LFT has been nothing but normal for forty years. I have confirmed liver disease and have just had a liver operation. I am not trying to worry you but your GP knows nothing. He should be sending you to a Gastroenterologist and Heptologist for tests. I also have good blood results. My advice is insist on seeing a Consultant NOW! Best wishes.

I am not sapphire21

[sunflower1 in reply to Tatjana]

I have already seen a hepatologist, said i had no stage of liver disease..what other tests do they do when bloods and scan are normal. What dies a gastroenterogist do? Thanks

[angelo212 in reply to sunflower1]

You saw a hepatologist which is the best person for the job. They specialize in Liver disease. Gastroentologist doctor specialize in all areas of the digestive system. Stick to the hepatologist.

[briccolone]

Right Sunflower-I went to the Camden road show earlier-found very useful-my fibroscan (the sonographer had some trouble finding my liver!) was 7.6kpa-no surprise -frankly was a bit relieved. Had a chat with the consultant from the royal free-she suggested what I already knew-lose some weight-more exercise and reduce the alcohol. She also said that 7.6 is not definitive fibrosis but an indicator-I suspect it was worse last year. So its giving it all up for Lent for me. I suspect some damage has been done but right now looks fixable. So in your case 6.7 ......could do with coming down a bit which you can do with diet/exercise/less booze etc.but unlikely any damage.-hope that reassures you...cheers

[sunflower1 in reply to briccolone]

Thanks for your post Briccolone... So did you think it would be worse than 7.6? So if you cut back on the booze and eat better you should be ok? Fibrosis is scarring is that right? My turn tomorrow, I am very nervous about it to be honest as I waas last year. Did you have to wait a long time to be seen? Did you tell them about yout (our!) symptoms. I will mention the fact that I read about itching being "end stage" liver disease.

[briccolone in reply to sunflower1]

hi-no didn't wait long-and yes to both those questions-look-If I had kept up with the abstinence and diet-my score would be lower-definitely! I'm going back on my 5:2 diet and avoiding alcohol except high days and holidays. Don't be nervous-better to now the facts-didn't mention symptoms actually but have just had my bloods done so will see the doc in 2-3 weeks-good luck

[sunflower1 in reply to briccolone]

An update for you. My fibro scan result was 6.3 which us down from last years 6.7, expert said itching was not related to the liver not mine anyway. Due to bloods, scans being ok. He said i should keep doing what i am doing. I.e safe drinking limits and i will be fine. He was going to suggest i was tested for pbc but i had already had this test in august.

[briccolone in reply to sunflower1]

good news-now keep up the good work-you can see it works!

[Lor7 in reply to sunflower1]

Hi sunflower1

Glad to hear you had good results.

Was your scan at Bristol? If so, how were you able to see the expert as I was just told it was normal and was rushed out. Did they do 10 measurements on you as I have posted on here that I only had 7 and now wonder how accurate that could be.

[sunflower1 in reply to Lor7]

Hi Lor7.. Thanks for your message sorry for late reply.

Yes mine was in Bristol. I made sure I saw the expert, thats why I went for the Fibro Scan and the chat. You perhaps should have insisted if you were worried. What was your score? I did have 10 Valid measurements. My score was down a little on last years which is good for me. Not sure about the Validity, perhaps google it? If you are under 7 you are considered as "normal"

[Lcarbon in reply to sunflower1]

Hi Bric', Lor, Sunflower - I too had a fibroscan at the Bristol Roadshow this year - My result was 6.7 and I was told that was normal - I did have to push them a little to admit that this was perhaps borderline. From the papers I have read, it seems that Fibroscan is good at predicting no / minimal fibrosis and more advanced fibrosis but less good at distinguishing in between. I did however pick up from various conversations I overheard that many people have managed to get their scores down with lifestyle changes - im hoping to go back next year to see if these have any impact.

[sunflower1 in reply to Lcarbon]

Thanks for your response Lcarbon.. Maybe I saw you at the roadshow! The more I read about the firboscan the more I think its "inconclusive" indeed like miost other tests. I think the onlu conclusive one is a biopsy which you will not get unless one of the other tests are abnormal, i.e bloods or scans..

[pwbr]

I had my first fibroscan at my local hospital in 2009 and got a result of 8.8. I was told at the time that whilst the result was somewhat on the high side I need not worry about having liver disease based on an 8.8 result

I had my second fibroscan three months ago in October 13 at the same local hospital and this time scored 11.3; as a result I paid privately for a CT scan which in conjunction with an US and blood tests has led my hepatologist to conclude that I have cirrhosis ( I am having a liver biopsy next month to confirm)

I attended the Liver Trust Roadshow earlier this week and had a further fibroscan but unfortunately the hepatologist operating the machine could not manage to obtain any reading whatsoever!

My own hepatologist recently told me that the fibroscan technology is not failsafe and in my humble opinion my personal experience with fibroscan is evidence of that fact.I just wish I had known that in 2009 - if I had, I would have followed up my fibroscan reading of 8.8 with other diagnostic investigations - at the time I knew virtually nothing about liver disease and was only too happy to be told that I need not worry about it.

If you get a very low fibroscan reading and have no other reason ( e.g. abnormal blood test results) to suspect liver disease then I suspect there is probably no real cause for concern but any result other than a very low one in my book means you should definitely pursue further investigations

A lot has been made of the advantages of non-invasive tests for liver disease such as fibroscan as opposed to a liver biopsy but I think fibroscan needs to be considered as just one of a number of potential liver disease tests - it is certainly not a procedure you can rely on to the exclusion of all else.

pwbr

[sunflower1 in reply to pwbr]

Thanks fir your post pwbr and sorry to hear your bad news. Fingers crossed fie a good result with the biopsy. I have had lots of blood tests and a couple of us,s all been ok so far. I understand your concern regarding the fibroscan though, i am dubious too.

[Hidden in reply to sunflower1]

Hi I have done alot of research on the Fibroscan and it is a very good way of getting the liver health, of course bloods, ultrasound, CT should be put in the pot aswel. The newer ones measure fat too, i had multiple bloods and ultrasound that found nothing, but the Fibroscan picked up a little than normal fat, so its very good for an early warning and to change your life style. By the sound of things you have a long drinking history and quite frankly the Fibroscan has told you to cool it, i dont see why your so dubious?

[briccolone]

not dubious in the slightest-it's quite clear what's required

[elenaki]

Hi sunflower1.

As far as i was told by qualified specialists a fibroscan is not always accurate. It tends to over estimate by 2.5 kpa in early stages of liver disease. I had a fibroscan and results were 9.6 kpa which suggests stage 3 liver disease. My liver enzymes were slightly elevated and ultrasound showed an enlarged liver. My dr wanted to do a liver biopsy because he believed i had Nash. Liver biopsy showed no fibrossis and less than 5% of fat on the liver whivh i was told was normal. Drs told me that in my case the fibroscan has overestimated my liver elasticity and with biopsy results i have no fibrosis ( scarring of the liver ).

[kippy2]

Hi I have had two fibroscans within the last six months, both showing a score of 2.9kpa. Which I was told means little to no fibrosis , but my ELF blood test showed a score of 9.9 which is severe liver fibrosis. I have had quite a few ELF blood tests over the last three years and all but one has been in the severe bracket. So, I don’t know what to think! Definitely confusing