Cirrhosis or hepatitis, or neither?

[Cardigan]

Hello I was diagnosed(via ultrasound,blood tests,endoscopy), with cirrhosis 2 years ago ( symptoms inc jaundice, ascites, weight loss, vomiting, "deranged" LFT,swollen legs, muscle fatigue) . Haven't drunk alcohol since and all subsequent blood tests have shown improvement, to the point that they are now "normal" , all other symptoms gone , however recently had another ultrasound which showed some liver damage contradicting the blood results.. was sent for a fibroscan the results of which were inconclusive , doctor thinks maybe I never had cirrhosis but hepatitis as blood work would not show such improvement if cirrhosis were present ? Would be nice to know if I ever did/ do have cirrhosis...

Awaiting further tests....any insight appreciated.

[AyrshireK]

You can still have normal LFT results even with cirrhosis, my hubby does. He was diagnosed with cirrhosis in 2012, listed for transplant in 2014 but delisted 10 months later due to his blood results becoming normal thereby taking him out of the criteria for transplant.

Certainly alcohol related hepatitis does give some similar symptoms to cirrhosis but the fact you had an ultrasound and the other tests which said cirrhosis would point to that being an accurate diagnosis. Perhaps doctors need to repeat your ultrasound to see what that is saying. If you have a diagnosis of cirrhosis it would be normal medical protocol to have an ultrasound scan every 6 months to check on the liver health, ensure no tumours or growths have appeared as well as checking your other abdominal organs.

I would request further tests and seek absolute confirmation.

Katie

[Cardigan in reply to AyrshireK]

Thanks, I have had a total of 4 ultrasound and 1 fibrscan , awaiting more I guess as previous ones are all "inconclusive " .. is cirrhosis reversible ? Would hepatitis not have been apparent in previous tests? I guess I'm trying to find some answers myself as the doctors seem perplexed ( and over worked !)

[AyrshireK in reply to Cardigan]

Cirrhosis doesn't go away, earlier stages like fibrosis can reverse and they think that even cirrhosis can reverse a little but a cirrhotic liver doesn't ever become healthy again. What kind of doctor are you seeing? preferably you want to be seeing a liver specialist who can do all the necessary tests.

My hubby was diagnosed following a presentation at hospital with advanced symptoms which almost came on out of the blue, since then he hasn't had any of the same and his liver is deemed to be stable and compensated ....... he still has some of the other symptoms of cirrhosis but not the late stage symptoms he initially presented with. His diagnosis was based on symptoms, ultrasound, endoscopy and liver biopsy.

Katie

[Porphyrogennetos]

What liver damage exactly did the radiologist refer to in his report for your recent ultrasound? Was it a colour doppler US?

Good luck,

P.

[susieanna]

What number was the fibroscan? I don't understand the inconclusive result. As you get the score in numbers there and then. It does sound like things have improved though due to your stopping drinking which is excellent news. Keep doing as you are doing. It sounds like the liver has at least stabalised itself. I would request to see a liver specialist though. But you have done really well. X

[Cardigan]

I don't know the technicalities of the scans I'm afraid, just repeating what I was told, and the doctor was a liver specialist although not the consultant.

[Porphyrogennetos]

Didn't the doctor give you some sort of a written clinical assessment? I am always given one together with my labs.

Cirrhosis is a histological finding. Cirrhosis can be definitely diagnosed via biopsy. If there is no biopsy available, the diagnosis is made by a combination of lab values, clinical findings (signs of decompensation like HE, ascites, varices, but also spiders, erythema etc) and radiological findings like distorted liver architecture, irregular contour, hepatosplenomegaly, nodularity, changes in the splenoportal system and in the blood flow to the liver.

None, or almost none of these signs, labs and scans alone is 100% specific and sensitive for cirrhosis.

That is why diagnosis is result of a combination of different factors, I believe.

P.

[7265sunlower in reply to Porphyrogennetos]

I've never had a written. Clinical assessment. I go back in September. Should I ask for one x

[Porphyrogennetos in reply to 7265sunlower]

I think you are entitled to one. It is just a printout from the system.

Imagine you get to see a different doctor who is not connected to the NHS system like a private doctor or one in a foreign country.

I have all my labs and assessment orderly kept in a file-book.

P.

[Cardigan]

Wow, I really appreciate you taking the time to reply to me, unfortunately a lot of what you have said is over my head ...the gist being only a biopsy can 100% diagnose cirrhosis? ( I haven't had one) ?

[Porphyrogennetos]

In advanced cirrhosis the diagnosis is pretty straightforward by imaging. a shrunken, nodular liver does not leave room for a doubt. It is in cases like yours, where symptoms like those you had could have been caused by aute alcoholic hepatitis e.g. and later vanish, where the recovery could mean that a) your decompensated cirrhosis went back into a compensated state in order to thank you for the lesser workload due to abstinence, b) you just had alcoholic hepatitis which resolved completely with abstinence or c) you had that bout of alcoholic hepatitis which resolved with abstinence but left what they call residual cirrhosis or d) something else

Keep doing what you are doing. You can't do anything else, anyway. Does not matter if it is cirrhosis or not.

P.

[Cardigan]

Thankyou, really helpful comments. ( unless it's "d ")

I'll come here more often 😉

[Porphyrogennetos in reply to Cardigan]

I just now read you had an endoscopy. I hope it was negative for varices as you did not mention them. If not, that would be a certain sign for portal hypertension which is a consequence of cirrhosis. If you have varices, you should have them checked regularly.

Good luck,

P.

[Cardigan in reply to Porphyrogennetos]

No varices.

[Porphyrogennetos]

Pleased to hear that. I was pretty scared before my first EGD, and turns out that a root channel session is much worse. Fear of the unknown I guess.

P.