Do I need endoscopy?

[susiebrad]

Hi hope some of you can help me. Recently achieved SVR after being treated with Sovaldi and I feel very lucky. At my next appt. I saw a doctor who after reading my fibroscan score - 12.5 announced that I needed an endoscopy as I was very likely to have varices! She ruined my positive news by scaring me half to death! Can they not determine whether there is portal hypertension from a Doppler scan ? Also being sent for bone density tests.

I had no idea I was having a fibroscan at the appt and had a meal prior to testing - I have read that this increases the score - scared but willing to have the tests, just want to know they are necessary!

[AyrshireK]

Hi Susie, glad you have had the all clear from Hep C - great news.

Sounds like doctors are now just running all the usual checks to make sure whether or not you have sustained permanent damage to the liver. The high fibroscan score might indicate that the Hep C has scarred your liver and as a result yes you might have portal hypertension and varices and the check on your bone density is just to check that your bones arn't thinning due to either medication or poor absorbtion of minerals (which can happen with cirrhosis).

So yes you do need these further tests to help ensure you don't have anything that might cause major issues going forwards. Portal hypertension and issues with blood flow can often been seen on ultrasound BUT they can't see individual varices and can't treat them (band them). This can only be done via an endoscopy so yes you do need that endoscopy. The scan for bone density (DEXA SCAN) is quick and painless just lie down, camera passes over the top of you ......... job done.

Your doctor is just being thorough which is a good thing, you've cleared the Hep C so it isn't continuing to damage your liver but whilst it was active it was attacking your liver so they do need to establish how much damage it did before the successful treatment.

Trust your docs, you do need these tests.

All the best, Katie

[Millie09 in reply to AyrshireK]

Hi Katie, good advice as usual. I am a bit confused due to the fact I am reading a lot about having a high fibro scan score means you have portal hypertension? I was just under the impression that it showed how thick the liver was due to the scarring 🤔x

[AyrshireK in reply to Millie09]

I hope I didn't cause any confusion. As I certainly didn't say a high fibroscan indicated portal hypertension. I did say that a highish fibroscan score might indicate scarring of the liver which in turn can lead to portal hypertension and varices.

You are quite correct in saying the fibroscan indicates whether there is any thickening of the liver tissue.

Sadly too many folks get them and then leave with a score but no discussion on what that score indicates and it seems to happen a lot. Different underlying conditions also score differently on the scale and it seems to cause no end of confusion and upset and is one of the most common queries on here - scores without diagnostics .

My hubby has never had a fibroscan. His cirrhosis diagnosis was made within a day of hospital admission based on results of an ultrasound and his symptoms. Only months later did he receive confirmatory biopsy result and a CT scan only happened during transplant assessment two years later.

Katie

[Millie09 in reply to AyrshireK]

Hi Kate, no I did not direct the actual query to you hun , I was just stating that I am seeing and reading quite a lot about fibroscan scoring and portal hypertension linked together. I have never had a fibroscan not in 9yrs since diagnosis untill Feb this year. They never even did the procedure when I was really poorly and I have never had a liver biopsy either. I have tried to contact my own dr since then but it seems now that as I am under the care of the QE HOSPITAL then I should direct any questions to them. I think more direct straight to the point answers should be given as you say there are a lot that are left in limbo, I for one will be armed with every question I want to ask and so has my sister 🙈. More questions need answers these days.. hope hubby is doing ok . Linda 😊x

[Newengland01]

A Doppler ultrasound can determine if you have portal hypertension because it views the blood flow Tati and from liver. I have had several dopplers.

[Millie09 in reply to Newengland01]

Really newengland1? I was never given the option? I just thought the only way was by endoscopy where they literally took them two months to get me to have one done 9yrs ago when first diagnosed with cirrhosis

I have only just been referred to a hepetologist whom I have seen once and due to see her twice on Tuesday this week as I am having a fasting scan done then an hour later I will see my consultant. I am just waiting for her to tell me I have to have an endo done 😐.but if I could ask for a Doppler scan that would be so so much better for me .

[Newengland01]

I have AIH and it was caught very early but I was not the normal case either. Usually another autoimmune disease is present with AIH but I don't have one. I have a bit of scarring which is cirrhosis but thank God it hasn't changed in the 5 yrs since I've been diagnosed. I have been in remission 2 yrs and had the option to stop meds but it can relapse so I decided to leave well enough alone. But I get complete abdomen ultrasound with Doppler to make sure blood is flowing properly and that there is no portal hypertension. Are you in Britain? Because I often why treatment is a bit different there then in the States.

[Millie09 in reply to Newengland01]

That's good news to hear your doing well ! Yes I am from the UK, are you from the states then? I do see differences in how different countries work, I have a few friends from around the USA and their system is slightly different.

[Newengland01 in reply to Millie09]

Yes I am from the States. I'm not sure why there is such a difference with certain medications and tests and doctor visits. But hopefully there is no need for you to get an endoscopy! I hope you also get good results😊

[Millie09 in reply to Newengland01]

Nice to chat to you 😊 well that's what I ask myself too , but I suppose the main thing is we are looked after correctly. Oh im so hoping I don't hear that word on Tuesday 🙉. I was told on my last visit I was now in f4 end stage but my liver was compensated. Fingers crossed 🤞. You take care 😊.best wishes linda

[Newengland01]

Also your fibroscan reading is not that bad! I was told above 20 is where concern arises. Also, just because you have scarring doesn't mean you have varices.

[Millie09]

Hi Susie, my fibro scan score is 27 😐. I have never ever been looked after properly in the 9 yrs of living with cirrhosis. My first hepetologist appt was in Feb just gone where I was given those results and now in f4 end stage, feeling pretty crap to be honest. ( excuse my language) .I will know more on Tuesday. Your fibro score is actually ok with regards to scarring .if you have to have an endoscopy you won't know a thing if you have sedation like myself. Just a groggy head and sore throat .hope all works out for you

[Dldtx]

It seems to be procedural, so far I have had a colonoscopy once, and a endoscopy once a year and a MRI twice a year since reaching SVR for the last two years I am sure this will change in length of time as needed. It would appear the need maybe used as a baseline If they haven't done one prior to achieving SVR. My thought is yes you need it

[toma123]

They normally do an endoscopy every couple of years if you have been treated for HEP C and have fibrosis in your liver. It is done to check for varacies but these are less likely to develop or bleed if you are cured of the HEP C. A Doppler ultra sound will tell them if the blood is flowing in the right direction from the spleen into the liver. If severe portal hypertension develops the direction of flow usually reverses.