From what I've been told by medical professions, they either make my liver disease seem very serious or no big deal. Anyone else?

My GP incorrectly diagnosed me with cirrhosis. I went to see a liver specialist who told me I had non-alcoholic fatty liver disease, not cirrhosis. I'm angry that I was incorrectly diagnosed, but I'm glad it's not the former. I have lots of mixed feelings. I know I need to lose weight (currently over 16 stone) to improve my liver but is my alcohol intake such a big factor? I drink twice a week, maybe 6 pints a beer at a time. Am I in denial? I've no idea.

[Fibro2021]

It's now recognized there are no safe doses of alcohol or safe alcoholic beverages at all. Individual sensitivity to the toxic effects of alcohol is highly variable. In other words, any amount of alcohol consumed regularly can lead to liver damage. It's probably safest stop drinking entirely, especially if the liver already has some degree of liver damage or liver disease.

[BritishLiverTrust1 Partner British Liver Trust]

You may find it useful to visit this area on our website, which includes links to information on diet, NAFLD and alcohol: britishlivertrust.org.uk/in...

Best wishes,

British Liver Trust

[MisterX]

Well you have far more to be thankful about than not - you really don't want cirrhosis.

Liver disease isn't always all that easy to diagnose so I wouldn't be too hard on your GP.

The following may help you. Inflammation of the liver - from any cause - is called hepatitis. Some viruses unhelpfully called Hepatitis viruses also cause inflammation of the liver but so can fat and alcohol and other things.

When the inflammation persists the cells that are inflamed turn to scar tissue. This scarring is called Fibrosis.

The liver is a huge organ with a load of spare capacity so a person can function normally on just 20% of their liver. Additionally it is the only organ capable of regenerating so if the cause of inflammation - the insult - is removed, the inflamed cells go back to normal.

If however the insult continues then more and more of the liver becomes fibrotic - ie scar tissue. The amount of tissue which is fibrotic is measured according to a number of systems and scales staged 3/4, 5/6 etc. depending on the system. The final stage of fibrosis, when more or less the entire liver comprises scar tissue, is called Cirrhosis. Cirrhosis is a measure of fibrosis.

Some doctors tend to use cirrhosis and fibrosis interchangeably and sometimes even refer to the process of getting fibrosis as cirrhosis.

Usually fibrosis short of cirrhosis will reverse itself over time if the insult is removed. It used to be thought cirrhosis was irreversible but there is recent evidence that in the early stages it can resolve. Once firmly established however it is progressive as the regeneration process replaces scar tissue with more scar tissue.

So overall you're not in a bad place. You definitely do NOT want cirrhosis if you can avoid it.

From someone who does have cirrhosis please please take this seriously. Without wanting to sound mawkish I'd give a great deal for the opportunity you have. You need to lose the weight - I found doing a slow version of the FAST 800 diet very effective (around 1200 calories a day) - it relies on not spiking blood sugar with carbohydrates so you don't feel too hungry. Worth investigating.

As for drinking I'd suggest you stop. It's not helping your liver not to mention the huge amount of calories in the alcohol which will be exacerbating your fatty liver disease.

Focus on losing the weight and recovering your liver health first. Once done consider resuming drinking sensibly - meaning not too many heavy binges and leaving several days for liver tissue to recover in between. Relentless drinking even of moderate amounts will increase fibrosis.

Hope that helps.

Best of luck.

[briccolone in reply to MisterX]

Good post Mister X!

[wurzle]

Thank you mister X for explaining the progression of liver disease so clearly and succinctly. I wish I had this information about 3 years ago before my cirrhosis turned that corner and progressed to full-on liver failure weeks after first being diagnosed. I sometimes think that the consultants work on a need to know basis, not wanting to impart too much information so as not to prompt awkward questions.

Hope all works out ok for you brodysbiggerboat x

[Roy1955]

BIG question is what additional tests did the liver consultant do to rule out cirrhosis?NAFLD is only one step from cirrhosis so needs addressing.

NO alcohol.

2x6 pint sessions is certainly harmful.

[MisterX in reply to Roy1955]

NAFLD - Non Acoholic Fatty Liver Disease is one of the ways the liver becomes inflamed and eventually scarred. Cirrhosis is simply a measure of how scarred the liver is.

Cirrhosis just means the entire liver has turned to scar tissue. NAFLD can be accompanied by a small or large amount of scarring (fibrosis) - up to cirrhosis depending on how long it's been going and when it's caught.

[Iro1]

Doctors in the UK are all over the place with the use of the term 'cirrhosis' . In one letter to me the consultant said to me 'you are not happy with your diagnosis of cirrhosis' and then said 'actually you are only on the cusp of cirrhosis'! The way I rationalise is that when they refer to cirrhosis they really are referring to fibrosis that is likely to be difficult to reverse, a 'cirrhotic process' not to actual 'cirrhosis' when the liver is severly impaired. In my case a fear of cirrhosis led to me attempting suicide. Clearly words are important, pehaps the British Liver Trust could feed back to the NHS on this? Patients end up spending a lot of time and worry on it when they should be enjoying life. I currently have the theasarus open trying to work out 'on the cusp' means!

[BritishLiverTrust1 Partner British Liver Trust in reply to Iro1]

This does seem to crop up on the forum regularly - we'll discuss it with our colleagues in the first instance.

[Iro1 in reply to BritishLiverTrust1]

I can testify to the severe mental (in my case suicidal) use of the term. I get sent away for 3 years and I dont have the 6 month checks so clearly in my case it is not cirrhosis in the strict medical sense as following the NICE protocols. Perhaps fibrosis that is unlikely to be reversed would be a better term? In the elderly population I would not be suprised if evidence of some fibrosis was greater than no fibrosis.

[KC108]

What tests did your liver specialist do to stage you. Have you been told your fibrosis stage?

[Benwillfred]

I was diagnosed with Fatty Liver and was a very light drinker high days and holidays with over indulgence maybe once or at the max twice a year. This was 25 years ago I was told that I could drink in moderation. Well now I have Cirrhosis and I wish that I had been told to abstain completely which I have now done for a few years. My consultant has now said alcohol is a poison and whatever you drink puts your liver under stress. So if I had my time again I'd stop drinking immediately!!

[Qwertrew]

How is it that they diagnosed with NAFLD? I'm not a doctor, but 12 british pints of 5%abv beer a week would be suspect in determining the etiology of liver disease, ESPECIALLY in a female.