Fibrosis and cirrhosis

[Kulwinder59]

What is difference between fibrosis f3 and cirrhosis stage 3?

[AyrshireK]

Fibrosis goes from F0-F4 with F4 being cirrhosis.

F0- No Fibrosis

F1 - Mild Fibrosis - Portal Fibrosis without septa.

F2 - Moderate Fibrosis - Portal Fibrosis with few septa.

F3 - Severe Fibrosis - Numerous Septa without cirrhosis.

F4 - Cirrhosis

Cirrhosis then can be categorized Stage 1 - Stage 4 with Stages 1 & 2 being compensated stages.

1 - Cirrhosis but with no varices / no ascites.

2 - Cirrhosis with varices / no ascites.

Stages 3 & 4 cirrhosis are considered decompensated.

3 - Cirrhosis with ascites, +/- varices.

4 - Cirrhosis with bleeding varices, +/- ascites.

I hope that helps.

Katie

[Kulwinder59 in reply to AyrshireK]

Thanks very clear replied

Fibrosis has in four part

And cirrhosis has four stages

-MEAN F4 has four stages ,is it ?

[AyrshireK in reply to Kulwinder59]

Yes F4 = Cirrhosis which itself is split inter four stages.

[Thumberlina in reply to AyrshireK]

Just out of interest, can any of these stages of damage be felt through the skin just below the rib cage. If the liver is normally of smooth texture, Would you be able to feel the bobbly texture?

[AyrshireK in reply to Thumberlina]

I don't think you'd be able to tell, a doctor might be able to gauge changes to liver size by palpating the abdomen but no I don't think you would be able to.

Katie

[Thumberlina in reply to AyrshireK]

Thank you Katie, I am being so educated by you guys on this forum. I was thinking if it is bobbly so to speak would you not feel it pressing it. Would all stages of Fibrosis and cirrhosis be picked up on ultrasound then, would it pick up fatty liver or does this not have stages of Fibrosis? it's all very complex and you can run the risk of assuming the worse reading Dr Google

[AyrshireK in reply to Thumberlina]

In simple terms what happens with liver disease is liver disease progression goes nomal liver (F0 - no fibrosis).

If it is being attacked by something (booze, infection, inflammation of some kind then it can become inflamed - in NAFLD or ALD it can also become fatty).

If fat and inflammation continue the liver will then start to try and protect its cells by throwing out collagen type fibres so you start to see fibrous tissue building up in the liver and this is what they call fibrosis - it is measured F1 (mild fibrosis), F2 (Moderate Fibrosis), F3 (severe fibrosis/incomplete cirrhosis).

Eventually so much of this fibrous tissue builds up in the liver that the texture of the liver completely changes - the liver cells get squashed by the fibrous tissue, they eventually get suffocated/starved and die off so portions of the liver actually become scar tissue and this is cirrhosis. (F4 fibrosis / end stage liver disease). When you have lots of dead cells in the liver the liver shape changes - in my hubbies case his has been described as shrivelled and shrunken. Picture your liver as a grape healthy and juicy but then imagine it as a raisin or sultana once it has dried out.

Earlier stages of disease may be missed on ultrasound scan but later stage normally isn't as the tissue density or echo texture as they describe it on a scan report is altered.

Fatty liver isn't describe as F, on a fibroscan it would be given a CAP score which relates to the degree of fatty change and this equates to a steatosis score and it runs from S1-S3 depending on the amount of fat in the liver.

Katie

[Thumberlina in reply to AyrshireK]

Wow, thank you so much for taking the time to explain. I have an ultrasound tomorrow I have arranged privately so if i'm reading this right they will pick up if it's more advanced.

I have pushed and demanded my GP calls on Monday to discuuss next steps if any I would like them to take so all advice is welcome. The receptionist tells me the tests I had that i've listed below are all fine according to notes on my file. Other than ALP 105 and Haematrocit .473 which apparently are both just marginally up so nothing to be concerned about. So I've no idea if the other results may have led them to believe there was nothing wrong. Anti-CCP antibody level

Haemoglobin A1c levelUrea & electrolytes

Serum TSH level

Liver function test

Serum C reactive protein level

Bone profile

Erythocyte sedimentation rate

Clotting screening test

Differential white cell count

Full blood count

I also had an upper body ultrasound bask in 2015 that was clear, so maybe they are using this as a marker for my liver today?

My worry was they weren't specifically checking for alcohol related issues, I genuinely did not know how bad I could damage it by social drinking. I drank a lot of wine, not necessarily every night but for a fair few years. Hopefully tomorrow will shed some light. If nothing else, reading the stories and experiences of others on here and the advice and knowledge people are kindly sharing has totally changed my outlook on alcohol and food.

😬

[Mavis2812]

2 yrs back my liver doc told me stage 4 cirrhosis but compensated..

[AyrshireK in reply to Mavis2812]

Some doctors use the terminology oddly - Stage 4 liver disease is Cirrhosis, F4 = Cirrhosis, End Stage Liver Disease = Cirrhosis.

Then cirrhosis is categorized as above. True stage 4 cirrhosis is the most advanced stage of cirrhosis and decompensated.