Can a liver really repair this quickly?

This was the results of my biopsy back in December: non-alcoholic steatohepatitis, grade 6/8 activity with no evidence of autoimmune pathology. There is also advanced fibrosis with bridging septa (stage 3/4) but not conclusive features of cirrhosis. Given my high fibroscan reading (30.7 KPa) the doctor said he would be treating me for advanced fibrosis / compensated Cirrhosis.

At my last appointment the gastro said that if my blood results are the same in 6 months he would be downgrading me to NAFLD and has changed the time frame for my gastroscopy, was due in November this year but said now November 2017 (the last one showed early varices) and then last week I had my ultrasound. This was done by a doctor rather than a radiologist which was unusual, it was the briefest ultrasound I have ever had literally in and out within 5 minutes, his first comment "was my fatty liver alcohol related?" sort of got up my nose a bit but then he went straight on to say ahh good no gallstones. I then said that was really good as my last 4 ultrasounds showed large polyps that changed to gallstones, so within about 10 seconds he said ahh yes you do have gallstones. He then said that my liver looked "almost normal" and he would compare it to the last ultrasound, and then said ahh yes much better.

Can my liver really go from the biopsy results above to looking almost normal in the space of 8 months? There is a bit of me that is really happy, but then there is another bit of me saying dont trust this idiot as he changed his mind about gallstones within about 10 seconds.

I dont want to be raising my hopes to see yet another gastro at my next appointment, I have seen 3 different ones over the past 7 months - I know my lifestyle has changed but there approach seems to have been all very different as well, and for them to be really negative again.

Really trying to be positive :-)

Anne

3 Replies

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  • Hi

    I think rejoice at the news that your ultrasounds are showing improvement and the doctors appear to be easing your future appointments, its a sure sign that their confidence that you arent at immediate risk is growing.

    When someone first shows up with a serious Liver condition usually the inflammation markers are all over the place and ultrasound/scans. Under these conditions it actually very difficult to asses the actual level of scarring(thats what matters in the end). The Liver can fully recover from Hepatitis alone, so the recovery is dependant on how much of the symptoms are scarring and how much is Hepatitis aslong as its not too severe. The ultrasound/FIbroscan and biopsy are to test different things, the doctors were cautious to start with because of the 30kpa FIbroscan and the biopsy showing heavy scarring. Stable numbers over a period of time are obviously positive and proves you are atleast still "compensated"

    Alot of people report that their scans look much better after removing the cause of damage, i.e. giving up Alcohol. The Liver wants to repair, the Liver will try to repair, even with heavy damage it re-routes pathways that let blood through so it can do its tasks, the scarring that hasn't bridged may be able to heal in time and fat will resolve. So improving your NASH condition has lead to less fat in the Liver and when there is less fat the swelling goes down and the Liver will do its best to repair what it can.

  • Thanks Ralph, there is alot of me that knows you are talking sense, but I suppose my struggling with the lack of consistency in approach is getting in the way a bit. I am having a multiscan the first Saturday in September so will be having another Fibroscan that will give me a like for like comparison - I wont be able to argue if that is better. Will also be having an MRI which I'm sure will be a convincer for me if all ok :-). I like numbers or facts rather than opinions, I forget they base these on years of experience even if they dont all agree :-)

  • I dont think you can accurately compare an ultrasound with a liver biopsy! They are poles apart in what they diagnose and in what detail. For example, ive had MRI scans for 6 years to spot any recurrance of cancer, but on an ultrasound what the radiologist thought might be a tumour turned out to be scar tissue. Like yours mixing up polyps and gallstones, sounds like the person doing the scan was guessing up to a point as to what they could see.

    The Multiscan, from what others have said, is amazing, and should give you the best picture - literally, in colour - of your whole liver.

    Do let us know the result, its a new technology many of us wish we could get access to. Good luck.

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