Dr advised to get a liver biopsy based on fibroscan

[alx24]

I had a fibroscan done last week and based on that and the 10 tubes of blood drawn that day the doctor advised to get a liver biopsy.

I’m hoping to get some advise on whether a biopsy is necessary.

I was referred to a liver doctor based on an MRI that showed possible fatty liver. Upon my visit to the liver doctor he had me get a fibroscan and blood work done that same day. Fibroscan result was a 7.6kpa median and 167 cap median. Blood result he said showed elevated enzymes. He also said not fatty liver but something about scarring. I’m not sure what any of these results/numbers mean but I’m a little concerned getting a liver biopsy and if it’s necessary.

Im including some added info if that helps. I’m 30 yrs old male. I’ve my gallbladder removed about 8 years ago. I also don’t have a weight issue. Weight has ranged between 130-150 lbs past 10 years. I also rarely drink alcohol. I took my first drink about 3 years ago. I don’t drink any beer or wine at all.

I would greatly appreciate any advise and help figuring this results out.

[Hidden]

Hi al

Welcome to this fenomenal forum 😁.

Why would you query having to have a biopsy? This is being done to aid your diagnosis. I wish I had had a biopsy before things got desperate! Best be very thankful methinks 😁👍

Good luck with the results.

Miles

[alx24 in reply to Hidden]

I only questioned a biopsy because I’ve had multiple invasive (colonoscopy, endoscopy) exams in span of about 4 years that my current gastro doctor said were unnecessary in such a short span of time.

[Bootandall in reply to alx24]

What was the purpose of these exams? Did you have polyps or varices or portal hypertensive gastropathy?

[alx24 in reply to Bootandall]

I was having constant abdominal pain. Current gastro said its most likely IBS and all those frequent exams were excessive in such a short span of time.

[Bootandall in reply to alx24]

But BUT you still don't know? Well "most likely" isn't a firm diagnosis.

ibssmart.com/?gclid=CjwKCAj...

I hope this link works, it's for a blood test advertised to obtain a specific diagnosis. I don't know anything about it but * I * would want more than a guess. Why did you switch gastros?

[alx24 in reply to Bootandall]

Switched gastros because I was tired of constant tests and getting 2min appointments with gastro telling me he wants to run more tests and is not sure what is wrong with me and wanting to give me a hernia check at every appointment even though I felt no lump or lift anything remotely heavy

[Bootandall in reply to alx24]

Ha, okay I get it. Miles and Trust1 are right though, liver biopsy is the gold 🥇 standard for diagnosing liver conditions. It sounds like the new guy is going in that direction for a reason. If you could get clarification on why exactly, it should help ease your mind. Let us know how it goes. Best of luck!

[alx24 in reply to Bootandall]

Thank you. Will update once I get the results of the biopsy.

[Hidden in reply to alx24]

Hang on....”in a span of 4 years” and you or that chap think this is a short space of time?? I would have said 4 MONTHS might be a short space of time!

[alx24 in reply to Hidden]

I felt that’s a short period of time considering they showed nothing wrong and I was in my late 20s and not an elderly person

[Bootandall in reply to alx24]

Okay, so the important nugget here is that repeated tests showed nothing abnormal, that's good 👍😁

So you see, it's really, really great you've had those tests out of the way.

[Kristian]

Hi Alx,

Sounds to me like the biopsy is necessary. There is something not right and it's better to get to the bottom of it. Getting an early diagnosis is helpful in a number of ways. Not least to ensure that you are looked after correctly in medical terms with correct treatments and monitoring. With liver disease there are many associated complications that can arise elsewhere in your body that can have pretty catastrophic effects. It's important they can pick these up early. So confirming a diagnosis now, even if the cause may not become clear immediately, will at least get you on the right pathway.

[alx24 in reply to Kristian]

I only questioned having a biopsy because I wasn’t quite sure what my fibroscan results meant. Is a 7.6 kpa not normal? I also had multiple invasive exams done in the past by a previous doctor that my current doctor said seemed unnecessary in such a short period of time.

[AyrshireK in reply to alx24]

Fibroscan results and what they indicate as regards liver change actually differs from condition to condition. In most conditions which cause liver change a 7.6 kPa result is putting you into the F1-F2 range of liver damage. Fibrosis is starting to occur. Doctors need to try and establish what is causing this to happen (hence the liver biopsy). If they can identify the cause of your liver change then they can either medicate for it and/or see if there are lifestyle changes that can slow progression or aid healing. Biopsy looks at the liver on a cellular level which is important when other causes of liver disease are not present - this is particularly important in some of the auto-immune or genetic conditions. Many of which are treatable.

Something in your blood tests has obviously highlighted a need to look at your liver in this way.

My t-total hubby has cirrhosis, never knew anything was wrong with his liver until he presented with late stage symptoms and there was nothing they could do to treat the cause of his liver ill health (burned out auto-immune hepatitis).

It's important to have the biopsy so you can treat your condition going forward.

All the best, Katie

[Kristian in reply to alx24]

I dont think any of us here are too knowledgeable on fibro scan scores and what the results mean. However, just looking on the tinterweb that sort of level seems to indicates that there is possibly some fibrosis. If its not clear on the cause then it's probably worthwhile getting an understanding of the actual degree of fibrosis. I do though see where you are coming from. In the UK they are reluctant to do biopsies unless there is a clear need to do so. Not sure if that applies elsewhere though. I can imagine in areas where you pay for treatments that there could be an alterior motive for you to be recommended to have another test, hmmm that'll be a thousand dollars sir. So I understand your scepticism. I still though think it's probably best to err on the side of caution with these things and have it done. Fibrosis can be reversed so it's good to get an idea of the possible degree and also possibly help identify a cause. Fatty liver from what you describe doesn't seem the most obvious cause. That's not to say it isn't but your info indicates otherwise, although that is purely from an uneducated viewpoint.

[Hidden]

Hi alx24

Welcome.

Only your own medical team can advise on whether a liver biopsy is clinically needed.

Often a liver biopsy is the only way to make a firm diagnosis and identify how advanced the condition is.

If you have some queries and concerns, you could maybe ask for another appointment with your consultant to fully discuss your results? It is important that they know your thoughts and comments too.

Best wishes

Trust1

[Hidden]

Hi Alx24

I cannot add anything but please take care and try not to stress. My fibro scan highlighted level 1 with a 4.5 KPA and a 259 CAP which my consultant wasnt concerned about ! I'm still be monitored until Sept which will be 16 months since liver concerns appeared.

Trish x

[alx24]

I would like to thank everyone for their replies. I was also hesitant for a biopsy because I was a little worried about the possible results. But like some people mentioned it’s better to catch something early then too late. I just scheduled my liver biopsy for next week. Now I just have to hope my insurance covers it because I don’t think I can afford it without insurance.

Thank you again and hope it turns out well.

[Hidden in reply to alx24]

Good stuff alx!

I hadn’t realised you weren’t in the Uk (free for us) and might have to pay. I would have amended my wording slightly 😁 - but not the bit about about the benefit of finding out early! Really hope your insurance pays for it.

Good luck 👍

Miles

[Bootandall in reply to alx24]

Hi Alx , Maybe you can get your insurance to pre-approve the procedure and in the process shed more light on the reasons it is necessary.

[clover90]

It’s good to hear you have booked your biopsy. My medical insurance covered mine. I was advised the biopsy was the final piece in the puzzle. It looks at the liver as a whole and confirmed I had AIH a month after becoming jaundice. 8 years later I am on no steroids only AZA and see my consultant every 6 months. My ultrasound which was done 30 mins before the biopsy confirmed my liver was healthy.

All the best for your biopsy results. Your mind will be put at ease once you know the results.