I saw my consultant on Saturday for a follow up. All my blood results have come back normal. They were testing for all liver diseases including some rare ones. I am pleased to report that he is finally arranging for me to have a liver biopsy to try to get some answers. I have non alcoholic fatty liver disease and mild fibrosis. He wasn't sure if I had been tested for Hepatitis C and B it could have been overlooked. There were no results for it in my notes so I have had the blood test done. If negative the biopsy will go ahead. Please could anyone help me with 2 questions I have. Firstly I am having the biopsy using a gun. Has anyone had their biopsy this way do you know what I can expect. Secondly, because I have Fibrosis does that mean that I also have Nash? The word has never been mentioned so I am just a little unsure. Thank you all. Hope you have a good day everyone.
Biopsy: I saw my consultant on Saturday... - British Liver Trust
Biopsy
I have never heard of a biopsy being done with a gun?? But if sounds like to me it's just going to be directly into your liver from the side of your torso which to me is the best way they get the best sample that way as well, it doesn't hurt, they numb it and in with a needle the worst part is lying still on your back for six hours
Fibrosis can be from fatty liver as well the biopsy will really tell them everything what's going on and advise you you may have to change your diet I hope you get the best results possible x
Thank you for responding to me. I believe the gun is a new procedure that is very quick so hopefully it won't be too bad at all. I have a history of chronic pain in liver area 10 years plus! I have had numerous hospital admissions where the liver enzymes have been raised and pain has been so unbearable I couldn't speak or move. My diet is extremely good and I hardly drink any alcohol. I am very relieved that I may finally get an answer although I am not optimistic about the chronic daily pain being relieved. I have had it for so long it has become a part of me now. Thanks again for the advice.
Hi
I had it done with a gun, they put a local anaesthetic I'm first which hurt a little and then did the biopsy which didn't hurt at all. I have Nash with fibrosis. Please take care. Love and hugs Lynne xxxx
Thank you Lynn that has put my mind at rest x
You are very welcome xxxc
I guess it all depends what kind of gun 😳. Just kidding love, you will be just fine. Its just a different tool to do the same job.
As for the NASH question the answer would be yes. NASH is the cause of fibrosis in NAFLD. The question is if or not it is active at this point. Remember that hepatitis is a greek word that literally translates to "liver inflammation" in English. Inflammation causes the damage and collagen comes to heal it resulting in scar tissue. When active it would have caused that cycle to occur resulting in the fibrosis. Because your inflammatory markers on your LFT tests are normal, that would indicate that the NASH is currently inactive. As long as the inflammatory markers remain normal, further fibrogenesis will not be initiated and the disease cannot progress.
Hi Phoenix thank you for explaining that part of my question so perfectly. I did think that was the case because I read that the Nash always precedes the fibrosis. I will await the results of my gun biopsy and hopefully the doctor has a good aim lol.
Thanks again
Technically it would precede it initially as fibrosis is the result of the healed injury caused from the inflammation of the NASH.
If the inflammation persisted it would be on an ongoing back and forth from there on where the NASH would keep causing injury and more fibrosis would build as a result of it continuing to heal every injury. This would keep going on till the amount of fibrosis scarring accumulated would be severe enough to be coined as cirrhosis.
NASH is not technically a disease in itself as it is a reaction to the disease. In this case NAFLD. It can happen acutely and stop for good in cases where the inflammation can be arrested by removing the insult like in NAFLD or Alcoholic Hepatitis. It can also be stopped if treatment is available to keep the inflammation at bay like in certain autoimmune types. (Katie would be more versed in the autoimmune department).
Sorry I blabbed a bit on there lol.
Thank you that explains it very well for me. Hopefully this biopsy will provide answers and i will then know the cause and what we can do to halt or treat the problem. I will update you once I have the results. I hope you are doing ok.
Yes please let me know what the doc says and how the biopsy goes. Best wishes Millie ❤
I have AIH (autoimmune hepatitis) and I have never been told I have NASH or NAFLD. I have never seen anyone in my group with AIH only being told that either. AIH is a separate issue from NASH Etc. So you could have fibrosis or cirrhosis and have AIH, but if that had been the case, then they probably would have seen autoantibodies in your bloods when they tested them. Don't know if that helps, but a biopsy will give a clearer picture. All the very best
Absolutely its a seperate issue. Who said it was the same? I think perhaps something got mis- read there. "It can also be stopped if treatment is available to keep the inflammation at bay like in certain autoimmune types". I was referring to inflammation caused by hepatitis in general and was using autoimmune types of liver diseases as an example of a situation where treatment can keep the inflammation at bay. Was not at all suggesting NASH was found in autoimmune diseases. Perhaps when I said autoimmune types, it sounded like i was meaning autoimmine types of NASH? Apologies, the way I wrote it may have come across otherwise.
I have to say when I read your post it sounded as if NASH was a component of AIH, hence my response. Glad it's all been cleared up
Thank you very much for explaining about AIH. This has been suspected by my Dr but as you said the auto antibody test was negative. I believe the biopsy is the best way forward for someone like me whose blood tests have not been at all helpful in diagnosis. My symptoms have often been that of a bile duct stone but each time there has never been any sign of stones. Hopefully the mystery will be solved soon. Thanks for taking the time to respond.
You are right about the biopsy. There are specific things that they will look for in the tissue samples that will tell them what type of hepatitis is occurring. It is frustrating waiting for answers, especially when you are having daily pain. Hopefully they will give you an answer soon, which will then resolve the pain. Good luck, the worst bit is the lying around afterwards.
Thanks so much. Yes I will take someone with me and something to read.
Hope it's someone interesting 😏
Hi Millie,
I had this done a few weeks ago and is relatively painless and in a big jessy. I had a pair of injections. First one nipped a bit that was just the local, then a second one a bit deeper. It was like the injections you get when going to the dentist. They then whipped out this gun thing.
It looks worse than it is and don’t worry although it’s a big needle type of thing they don’t put it all in. Then get you do do some breathing exercises as you need to take deep breaths, to get your lungs sit the way when doing the actual biopsy. The ‘gun’ makes a bit of a noise as in a bang, but they will let you hear it first so you don’t jump. I was trying to describe the noise but it’s hard too. It’s not loud anyways.
Then that’s it done. I had to try and still and as flat as possible for 6 hours to help things clot. Then that’s it all done and your off on your merry way.
Hope this helps as I didn’t know what to expect.
Cheers
William.
Thank you William that helps me a lot. I know now what to expect and it doesn't sound too bad. The worst bit is probably the local anaesthetic like at the dentist. Thanks for your input. I know I will still be nervous on the day but that's to be expected. At least there will be no surprises now.
No worries Millie, glad that it helped. Good luck with it all and let us know how it goes.
Cheers
William
I had a liver Biopsy recently and they said they wanted to 'Zap' a 'Nodule' at the same time using a special Radio Frequency probe. I wasn't very happy about this because they didn't even know what it was exactly. I think it was a case of 'better safe than sorry' or simply for reasons of expediency. Anyway, I said I'd rather wait until the results of the Bioposy came through as this seemed more logical to me.
Also I mentioned to the specialist that I had a wart on my back for many years without causing me any problems and asked if internal organs also had similar imperfections. He said Yes, they do.
So, I just had the Biopsy done. The thing is I still haven't had the results over 4 weeks on.
A case of 'No news is good news' I'm hoping..
Ron
Hi Ron I hope you are not waiting much longer for your biopsy results. Four weeks is a long time to wait especially when you are anxious about something. Hopefully the nodule is nothing to worry about and you get good results from your biopsy soon.
Liver Fibrosis
Small update after liver biopsy and blood work
Biopsy 
Liver Biopsy
