British Liver Trust

New and confused....any advice would be helpful.x

Hi....sorry to bother anyone. I'm confused. I had a scan which showed enlarged liver with coarse echo texture and fatty infiltration, with pan portal hypertensive gastropathy.....I've had a fibroscan today with a score of 6.1. I don't drink or have any risky behaviours. I'm getting mixed messages through googling as its saying PHT is only present in advanced stages???? Can anyone shed some light please. Xx

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If your condition is Non-Alcohol Related Fatty Liver Disease (NAFLD) a Fibroscan score of 6.1 would put you in the bracket of F1 fibrosis and this would be backed up by an ultrasound scan showing you have fatty infiltration and coarsened echo texture. I don't know how they have managed to diagnosis portal hypertensive gastropathy without an endoscopy as it can't be seen on a scan (unless it was a super dooper 'dynamic' CT scan with barium). Diagnosis of this condition is normally by endoscopy or capsule endoscopy. Sometime you can have portal hypertension without cirrhosis.

Hopefully you have follow up appointments in the pipeline to fill you in on what the results mean and what treatment plan they have.

For information on NAFLD there is an excellent page from the British Liver Trust at:- britishlivertrust.org.uk/li... It can perhaps give you more information on the condition and provide pointers as to what you might be able to do to slow down or even reverse the damage.

Best wishes, Katie

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I have an auto-immune disease of the liver and I have had episodes with portal hypertension despite the biopsies saying I don't have cirrhosis and I have a low fibroscan score (slightly higher than yours). From talking to my consultant at the QE, it seems that the reason that you can have "opposing" information like this is down to where the liver is initially assaulted. They are doing research in Germany, whereby the liver is scanned for where the liver injury is initially occurring and then linking this to the outcome of peoples' disease. However, all this tells them is that if your liver is initially assaulted in certain areas, then you are likely to have a more aggressive outcome (or not) depending on the initial assault.

For the moment, the medication that you are given is exactly the same regardless of this extra information, which is why the UK has chosen not to utilise this same method of research, since your treatment would not be affected. However, the German research does explain why there can be a discrepancy between biopsy results (and other test results) suggesting early stages of liver problems and actual happenings being somewhat more advanced.

I hope this goes some way to explaining some of your questions. This information is new to me in the last 12 months or so, and has come from one of leading consultants in my particular type of disease, so is unlikely to be known by others not at the forefront of research into these matters.

All the best :)

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Tests are never perfect. My first ultrasound said I had a fatty liver. Later MRI and then biopsy said that wasn’t the case. Anything interpreted by a radiologist could have errors for many reasons. And all of the algorithmic tests are just statistical best guesses based on several factors, but there are always outliers.

As for portal hypertension - it is possible without fibrosis or cirrhosis. It’s a whole subclass diagnosis caused by a host of other things causing vein issues including blood coagulation.

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Thankyou everyone.ive managed to bring my follow up appointment forward to April. I'm so impatient. I've already started following a healthy liver diet. Even if nothing is wrong it's good to get healthy. My issues are probably minimal compared to others here so my best wishes to anyone struggling. Xx

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