Hi,I had my gallbladder removed a few weeks ago as I had gallstones which were seen on ultrasound after I'd had pain/pressure/a full feeling under my right ribs.
During the op, the surgeon has seen what he has described as "excessive fibrotic changes in the liver".
My GP has referred me to Hepatology for review, no idea how long that might take.
My most recent LFTs that I'm aware of were done in April, and they were all within normal ranges. So my question: can LFTs be normal with fibrosis?
I'm really scared - my Mum had PBC, diagnosed at an advanced stage, from which she died a decade ago. Any experience or words of wisdom, I'd be really grateful.
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Sorry, forgot to say - the pain/pressure under my ribs has persisted since my gallbladder was removed, and I've been exhausted for months, although that could just be because I don't sleep well.
Well what a coincidence, I had my gallbladder removed on 4-12-23, after a year on the waiting list and many infections later... Firstly its normal to experience pain in that area because of the gas used in the procedure, if keyhole surgery was performed. This should disappear gradually, but post operative pain and soreness can be experienced, and indeed I have experienced it at various degrees for 10 days, gradually reducing all meds at moment as pain has stablized and is gradually going away, if this gets worse or doesn't go away after three weeks contact the consultants secretary, the number should be on your discharge papers, and they do encourage you to contact them should any post operative problems occur. As for the Fibrosis, I'm afraid I have already been diagnosed with this two years ago F3-4 with bridging, my surgeon was quick to say it hadn't got any worse, which because of the delay in surgery was a miracle in itself. You are now with heptology, they will act on the surgeons concerns, and I'm sure you won't have too long to wait for an appointment. As for causation mine was a mixture of all 3 Nash,meds, above weekly recommended intake of alcohol. As a result ive not drank since diagnosis, lost weight, although under heptology dietician to help with that as it's not easy, meds is difficult as I have a disability which causes pain, so reducing and looking for alternative to liver damaging pain killers is a constant problem, but one I hope to address as best as I can.
Obviously PBC is not the cause of my Fibrosis, and I do understand your concerns, with family history, there are drugs available to slow the process down, and indeed research going on all the time, but obviously you need a causation diagnosis ASAP, so your treatment can move forward.
Hello, LFT stands for Liver Function test, so the bloods are a good indication of how well your liver is functioning, whether or not there's fibrosis. This is a really positive sign for you. Once the cause of fibrosis is established then things can be done to halt it and maintain the good liver function. It looks like they have jumped onto it and doing the right things.Wishing you all the best.
Thank you - I know what lft stands for, I'm just too lazy to type it! I'm having more bloods done soon, hopefully they will be good too. Hopefully my referral to Hepatology won't take take long, the waiting is the worst.
This is my hope. However, I never really had any severe attacks and my gallbladder wasn't infected or inflamed, according to my surgeon, so I'm not sure.
My LFTs were normal right up till my liver transplant, platelets and inr were extremely abnormal, my consultant said I was a difficult case and it took 7 years to diagnosis cirrhosis after I had a massive variceal bleed.Hilary
Thank you for sharing your experience. My platelets have been low for years and my bilirubin is consistently slightly raised (which is Gilbert's as far as I know), not sure what inr is or if I've ever been tested for that? I hope never to have a varices bleed, my mother did and it was terrifying. I'm sorry you've been through that.
AST/ALT are signs of smoke. But the fire may be out aleady. Meaning AST/ALT can be normal due to there is no further liver cells to release them.
ALP, GGT can still rise, Bilirubin, and PT are the ones they keep an eye on for synthetic function. Even those can be caused by other things. So it tends to be a lot of things they take into consideration.
In my wife's case a CT in Jan of 2020 showed a normal liver, Sept 2020 fatty liver, Oct 2020 sever fatty liver. Biopsy in Oct 2002 showed NASH Fibrosis 2/3 meaning Briding Fibrosis, with a maintained liver architecture (important) A second Biopsy's was done in June of 2021, and showed Fatty Liver, with a Fibrosis score of 0/1 mild ballooning, with no bridging. I did not think that possible. During that year her liver went from 13.4 cm, to Oct 2020 of 30cm, and June 16cm
During that time AST bounced all over the map. INR/PT remained stable, ALP, LD/ALT were always perfect. GGT would be mildly elevated.
Actually no, she had a condition "Aggressive non-alcoholic steatohepatitis following rapid weight loss and/or malnutrition"
She had caught covid, and loss over 100lbs in 6 months. The rapid weight loss overwhelmed her liver. Apparently it is very dangerous, but if you survive the initial hit the liver responds very well.
She did pass this past year not from that. But there was much confusion. About reading her chart. She was suffering a hemolytic reaction to Cefraxone, combined with a sever AKI caused by Vancomycin. She died in her sleep from Renal Failure when her Vanco Trough levels hit 86+ and her kidneys shut down.
The best luck you've had was that you know, because of your Mom's experience, the true value of getting diagnosed and treated as early as possible. You have caught your condition early enough. You fortunately do not have cirrhosis. You have some degree of fibrosis. Fibrosis, everyone agrees, is reversible.
About your LFTs, as others have said, these can be normal even with fibrosis. That's good news. It means that your liver is still doing the jobs that livers are supposed to do. It also means that you do not have inflammation. This is very important because many doctors believe (and studies show) that inflammation is one of the key, if not "the" key, step that leads to fibrosis and cirrhosis, if left unchecked.
So, great news that your liver is functioning. Great news that you don't have an inflamed liver. Great news that you've been diagnosed and are under the care of a heptalogist!
Please search this site and you'll find various diets and tips that have helped people to reverse their fibrosis. Have a great day!
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The value - or not - of Liver function blood tests…
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