Progression of liver disease

[Watersk]

From fatty liver do you always progress to hepatitis and then possibly cirrhosis? Or can you go straight from fatty liver to cirrhosis? I couldn’t find anything online that answered this question.

Thank you

[Fibro2021]

I had to read that in some cases the transformation to fibrosis and cirrhosis is possible with ARLD bypassing the stage of alcoholic hepatitis. Maybe others will add me.

[AyrshireK]

Have you seen the BLT page on ARLD?

britishlivertrust.org.uk/in...

Various diagrams on line deonstrate the differing progress routes with alcohol related liver disease. Alcohol cessation can stop progress.

Alcohol related liver disease progression.

[MINTVCX]

About simple fatty liver I found below:

"NAFL is a form of NAFLD in which you have fat in your liver but little or no inflammation or liver damage. NAFL typically does not progress to cause liver damage or complications. However, NAFL can cause pain from enlargement of the liver"

niddk.nih.gov/health-inform...

"NAFLD states as simple fat, which impacts and 20% to 30% of those individuals who progress to nonalcoholic steatohepatitis (NASH). Another 20% to 30% of individuals progress to more advanced NASH fibrosis, and the final stage is NASH cirrhosis. It used to be thought that progression from early stage NAFLD to cirrhosis took decades, but recent studies have shown that some people progress rapidly within 2 years. However, research has also shown that there is reversibility."

ajmc.com/view/nash-has-gone...

But tricky part is here you can suspect NASH by some blood test (simple LFT or more accurate tests) but only biopsy is conclusive to confirm it with highest probability.

[Fibro2021 in reply to MINTVCX]

The whole complexity of the forecasts lies in the fact that a particular patient may have overlap syndrome. For example, a person with a high BMI + regular alcohol consumption. In fact, it's more correct to sum the damaging factors with the identification of the leading factor if it possible.

[DavyGravy]

I think the way I look at it is... there are stages of fibrosis 1 to 4 then stages of Cirrhosis 1 to 4 ... but lets just say stages of liver disease 1 to 8. If you have stage 1 you cannot jump directly to 8... it's not like monopoly, "go directly to jail do not pass go" you will have to pass through all the stages to get to 8.

Most people with a pain in their side and are told they have a liver problem will assume it is serious (it is) but most cases are not cirrhosis stage 4, but anxiety will tell you every minor twinge under the ribs means you have gone from stage 1 to stage 8 and skipped the other stages. It is impossible!

Someone might deteriorate so quickly that they do not spend long in each stage but they'd have to be abusing their liver badly or have a very serious autoimmune disease or underlying problem/ reason. Try not to worry... stress, anxiety and depression are just as debilitating as physical problems.

Dave

[Zukosmile07 in reply to DavyGravy]

Well written Dave, when the disease spreads within you and you are in hospital listening to the consultants and specialists, all you hear is you have liver disease caused by alcohol consumption.(That is in my case) you also never hear non alcoholic liver disease which refers to being a alcholic. Then the consultant tells you you have alcoholic hepatitis liver disease, I've never heard or seen AHLD and I had both a Alcohol related fatty liver disease and also alcoholic hepatitis liver disease. So what is that ARFLDAHLD, how is this going to help people who are struggling to come to terms with the nasty, horrible disease unless you incourage them to use Google which we all know is a no no.

Now this for me was over 10 years ago and I didn't have a fibroscan and never was fibrosis or Cirrhosis mentioned. However I did have a MRI scan and a CAT scan. Which only indicated the above ⬆️.

I was 30 and it was drinking to excess and what comes with that lifestyle is takeaway's, eating on the run, sandwich shops/chippy's at work, full English breakfasts. (My liver problems)?

Stopping the alcohol and changing the way I was eating and the vitamins, frolic acid tablets, gastro-resistant tablets all helped and reversed the diseases completely according to the in-depth accurate blood test, never heard LFT I'm assuming it stands for liver function test. Now the blood test didn't pick up Cirrhosis, over 2 years later when all blood tests were still normal and I wasn't classed as an alcholic. I started drinking again and because of the cirrhosis the liver disease rapidly increased but I felt fine.

Non alcoholic related liver disease must have underlying problems to make that jump to Cirrhosis. While being in hospital and meeting people with different forms/causes of the disease. I learned that some people were taking too many paracetamol but also an over eater which was classed as non alcoholic fatty liver disease. They found out later when the truth came out about the paracetamol and ibuprofen (not mentioned) he had Cirrhosis and little spots all over his liver. He was 23. Then a lady who had a CT scan because she suffered from chronic abdominal pain on a flight. It picked up cancerous lumps on her liver (4 and she was very lucky). She had a transplant 2 weeks before mine also classed as non alcoholic related liver disease. (Her terminology)

Listen to the doctors and change your lifestyle to healthy is the only way to stop the disease from starting, liver cancer is completely different, which needs to be addressed with some sort of periodic scan (or something) as a safety measure. Also blood disorders but that should be picked up on with every blood test.

Sorry guys, I mean I can understand all the abbreviations but I have suffered over 10 years (easy for me) some people will read this and not have a clue, either not bother writing in or Google it (everything is abbreviations and leading to death). Not having a go so Shoot me down I'm just saying like....

Danny x

[Watersk in reply to DavyGravy]

Thank you Dave for a very clear informative response. Of course it makes sense when you lay it out like that. My only query is do you always know you are travelling through the different phases 1-4 until you’re actually in phases 4 and all hell breaks loose. I’ve read you don’t always have symptoms until things are really bad so no warning to get your act together quick. Is this really true that you may not have even a symptom?

[DavyGravy in reply to Watersk]

The liver feels no pain but as liver disease progresses, there can be warning signs (often these may not be liver disease at all) but they can add up enough to get a GP to run tests. But provided we eat healthily, exercise and have no serious underlying conditions we should not progress to cirrhosis.

Only Anxiety will keep saying "you have cirrhosis" when tests and scans say otherwise.

I don't worry about it now, I'm too busy enjoying every day looking forward, rather than constantly checking over my shoulder for cirrhosis (it cannot catch me as I am walking in the other direction )

[Bazinga89]

Hello. I have same thoughts if that progression is possible... My diagnosis is fibrosis with steatohepatitis but getting more and more symptoms... fun fact is that I stopped drinking, eat very healthy (no fat,no sugar) and excercise a lot but last week I got varices burst... so I have same question is possible that even with stick to your doctor advices to progress get worst?

[Zukosmile07 in reply to Bazinga89]

You see the advice is to try and prevent liver disease and all the problems that come with it. I had lots of varices but never had a massive bleed. My endoscopy results state they were bleeds but that was back in march/April and I had stopped drinking for nearly 6 months. You need to go and see your consultant and have some tests urgently. I cannot give you the answer without you knowing the condition of the liver.

I mean have you had any stomach problems, heavy coughing, bad cold?

Also everyone is different I know my liver got worse through my diet. If my liver didn't like what I was eating and couldn't break things down (get rid of toxins) it used to let me know. I believe a sudden change used to deteriorate my liver but it was already so scarred.

Please get checked and not just blood tests.

[user2021a]

I went from healthy liver to cirrhosis in 3 weeks but that was due to blood clots in the liver which put me into liver failure and suspect the earlier stages progressed rapidly. The cirrhosis is only in patches and luckily the rest of my liver has regenerated and taken over most of the functions.

[Zukosmile07 in reply to user2021a]

Wow I mean wow that is from just stopping working? I mean I have only heard that from you. You see the way it was described to me was as if the liver had a jalt when it wasn't working properly which inturn scarred it. It is not just like that, it's a chat I had with the liver nurses and trying to get my head around it. It has to deal with so many things at once and you throw something at it that it doesn't like, even lack of blood it won't operate properly.

[MalcolmCClark]

HiI was diagnosed with a fatty liver and although was informed at the time that complications may occur in the following years I didnt give it a second thought. No follow up happened by a hospital consultant or from my GP. About 15 years further on in 2017 I had stomach bypass surgery. They found my liver to be scared and lumpy. The surgery was stopped and a biopsy was carried out. The biopsy confirmed i had liver cirrhosis. I have since had a lifestyle change and my liver seems to be slowly recovering to the point that my gp now questions my cirrhosis diagnosis. That's even though I have 6monthly checkup at Kings College. So in answer to your question I did go straight from NAFLD to Liver Cirrhosis. I asked the question to my consultant. Do I have Cirrhosis and he said yes but can also be referred as NAFLD in my case both terms are true.

Yes I'm still confused as well. But the fact I still have 6 monthly liver check ups with 6 monthly ultrasound scans and 3 yearly endoscopic and fibro scans Kings do take my condition seriously.

[DavyGravy in reply to MalcolmCClark]

I think you might have misinterpreted something in this thread Malcolm. The OP asked can you go straight to Cirrhosis and bypass other stages. The answer is yes if there are serious causes such as user2021a's blood clots.

I don't think your own progress into cirrhosis happened overnight, I would guess that it took 15 years and you passed through the other stages in between.

Also, I think (and hope someone will correct me if I'm wrong) that cirrhosis is the condition of your liver and NAFLD is the cause. We can have cirrhosis from, alcohol abuse, autoimmune disease, viral, and other causes...

In my case I have hepatitis C, I am lucky as I found out at stage 3 fibrosis. I could still end up with cirrhosis, simply by not taking my medication, then I would have cirrhosis but also have HCV... just as you have cirrhosis and NAFLD. I hope that makes sense

Dave

[Hidden]

May I ask how you were diagnosed was it found in a blood test first. My son has been called back for a 2nd blood test scared beyond belief and googling everything. Hope you don’t mind me asking

[Watersk in reply to Hidden]

I haven’t been diagnosed not as yet I’m just making enquiries.

[Hidden]

May I ask what storms your having