interpreting results

[sheperd86]

Hi, hope you are all coping OK. I just have a little query. I was diagnosed during covid lockdown and it was a complete shock. Fatty liver had only ever been mentioned as an aside when looking for other things. My latest letter from my consultant says "compensated Nash cirrhosis,

[Roy1955]

Your Dr should be the person to explain it to you.You certainly need to nurse your liver along and treat it gently.

As for "how close to being decompensated" nobody can estimate that.

The thing to aim for is to remain compensated!

[AyrshireK]

Hi Sheperd, welcome aboard.

Sorry to hear about your diagnosis. Whilst we are not allowed to interpret specific results I'll try and help out with some of the terminology.

Decompensated cirrhosis isn't determined based on any score on the charts but by symptoms present. A compensated liver is able to carry on a lot of it's 500 functions but when it becomes decompensated it struggles with even tge ones essential for life. Symptoms of decompensated cirrhosis would include ascites +/- bleeding from varices.

Child Pugh score runs from A-C with A being at the less serious side of the score.

Meld/UKELD can give doctors an indication of potential transplant need and are calculated from blood test results.

NASH (Non Alcoholic Steatohepatitis) is the more agressive form of Non Alcohol Related Fatty Liver Disease. Your CAP score reflects a very fatty liver since CAP only scores up to 400.

kPa is the figure that reflects how fibrous your liver is and has given you your cirrhosis diagnosis. There is a chance that your kPa could potentially be falsly elevated to some degree since NASH indicates ingoing inflammation and fibroscan sometimes can't tell the difference between actual fibrous tissue and inflammation.

All us not lost however - if you can tackle the underlying cause then there is a chance your liver and all your scores can improve to a degree. The BLT has an excellent page all about NASH & NAFLD which provides guidance resources on what you can do to help your condition. britishlivertrust.org.uk/in...

Katie

[sheperd86 in reply to AyrshireK]

Thank you for your response. Really helpful. My liver was finally tipped over the edge by medication I had been on for several years for an unrelated condition. Lover dr insisted I be taken off that med and I haven't been on it since diagnosis but unfortunately that means that my other condition isn't being treated as effectively. I have queried whether it is true cirrhosis (after finding out in January I had been treated for a form of blood cancer for 10 years, which they have now said was misdiagnosed. I think I am looking for more definite answers than can be given but I just like to plan for eventualities before they arise.

[AyrshireK in reply to sheperd86]

Obviously you need a very thorough chat with your liver doctor to establish exactly what is going on.

Still - all isn't lost. My hubby was diagnosed with decompensated cirrhosis with a massive bleed from varices in April 2012 (due to auto immune liver disease). In 2014 he was assessed and listed for transplant and delisted after 10 months because his situation improved. All these years later he remains stable and we are just back from a 4 week caravan holiday where we did 335 miles riding our e-mountain bikes in the North York Moors and Yorkshire Dales. He is monitored regularly by his liver doctors and keeps generally well (not 100% fit and well by any means but living his best possible life).

Katie

[sheperd86 in reply to AyrshireK]

Wow, that's great news for your husband. Life is always about one day at I time.

[Iro1 in reply to AyrshireK]

hithank you for sharing that massively inspirational story. I think 'generally well' not '100% fit' covers many peoples experience with liver disease.

Making the best of things is essential, to come back from April 2012 like your husband has is amazing.

Keep well

regards

Iro

[Iro1]

Hinice to meet you, sorry to hear about your results. I had an initial kpa of 10.8 and CAP of 348 in summer of 2019, by the summer of 2020 9.8 and 308 so it can come down. Never had any mention of MELD or Charles Pugh signed off to the summer of 2023 as my liver is now 'stable' whatever that means.

Healthy diet and exercise is obvious but as a man I also receive Testosterone HRT which is far more effective than anti depressants! I have not lost much weight but lost belly fat and no longer pre diabetic also max out on pressups every day.

I have no idea or experience of how sex hormones are affected in women but worth asking.

If I could identify one good treatment in my experience for fatty liver/cirhosis it would be the normalising of these hormones in my body. Worth asking your consultant about this issue.

Please look after yourself and I am sure that things can improve if you follow the advice of your medical professionals,

regards

Iro