NASH and progression

[Splodge60]

Using a biopsy I was diagnosed with this Fatty Liver problem in 2002 or thereabouts. My GGTs are regularly between 1000 and 2000 and other enzymes are also raised but not as dramatically. I do not drink any alcohol and have never done so. When my LFTs are checked regularly I keep being told......they’re stable figures so it’s ok. I’ve just persuaded my diabetic Registrar to send me for an Ultrasound of my liver. I fear that NASH has progressed to Fibrosis which concerns me. Is anyone else in a similar position and keep getting fobbed off. I am a 68 year old female

[Kristian]

Hi Splodge,

I found the same, for a long time my LFTs tests were pretty stable. I was told the same. Apparently what they tend to look for is trends, so if everything was stable they were happy to just watch and wait. Its usually when things changed that they tended to do more investigations with me. Those weren't necessarily just those test results that changed, but also significant symptom or actual synthetic liver function showed some form of degradation, or was degraded below normal for a period of time. Basically they just wanted to make sure it wasn't just an isolated instance.

I would though have thought, with results like yours, that they would have done some follow up ultrasounds just to check on progress, even if it was only every couple of years or so, as something looks to be consistently going on.

So, just to summarise, i don't think your docs are purposefully fobbing you off. But, it would be sensible to ensure you do have some additional monitoring. An ultrasound every year or two initially seems sensible to me. If anything is highlighted, or not, that can then determine if more frequent, or less frequent, reviews are necessary. It would also highlight if things like portal hypertension may have arisen. The ultrasound should therefore need to cover your spleen not just your liver. If its an abdominal ultrasound that has been ordered it should cover that, and your kidneys too. Which is useful from a diabetic point of view too.

Hope that's, helpful.

Kristian

(ps - great username)

[Splodge60 in reply to Kristian]

Thank you Kristian, I have just managed to persuade a Registrar Locum to send me for an ultrasound on my liver. Don’t know if they’ll do anything else. I am hoping that it will clarify things but who knows? What does a test like this reveal for eg. Would it show fibrosis?

[Splodge60]

Well, things are moving forward now. I am being referred to see a Gastroenterologist but no idea when because of vomiting blood and all other liver and/or stomach problems. I’m still not eating and all fluids now come back. Just had a vomiting episode and it produced 2inches of blood into sick bowl. Ah well, these things are sent to try us xxx