Fibrosis risk score

[tinkerbelle65]

Hi everyone, I had an ultrasound which showed I have NAFLD. My GP ordered more bloods to be taken in order to do a fibrosis risk score test. I have been informed that my score has come back "quite high" so I am now being referred to the hospital. Could someone please clarify in plain English what this actually means and what I can generally expect to happen next as my mind has gone into overdrive. Thanks.

[AyrshireK]

Here are the NICE guidelines for assessing the likeliehood of advanced fibrosis in those with NAFLD. The full document is available at:- nice.org.uk/guidance/ng49

1.2 Assessment for advanced liver fibrosis in people with NAFLD

Identifying people with advanced liver fibrosis

1.2.1 Offer testing for advanced liver fibrosis to people with NAFLD.

1.2.2 Consider using the enhanced liver fibrosis (ELF) test in people who have been diagnosed with NAFLD to test for advanced liver fibrosis.

1.2.3 Do not use routine liver blood tests to assess for advanced liver fibrosis in people with NAFLD.

1.2.4 Diagnose people with advanced liver fibrosis if they have: an ELF score of 10.51 or above and NAFLD.

1.2.5 Refer adults and young people diagnosed with advanced liver fibrosis to a relevant specialist in hepatology.

1.2.6 Explain to people with an ELF score below 10.51 that: they are unlikely to have advanced liver fibrosis and reassessment for advanced liver fibrosis every 3 years for adults and every 2 years for children and young people is sufficient for regular monitoring and no interim tests are needed.

Give the person advice about lifestyle modifications they may be able to make (see section 1.2).

1.2.7 Offer retesting for advanced liver fibrosis for people with an ELF score below 10.51:

every 3 years to adults

every 2 years to children and young people.

1.2.8 Consider using ELF for retesting people with advanced liver fibrosis.

Monitoring adults and young people over 16 for cirrhosis

1.2.9 Monitor adults and young people over 16 with NAFLD and advanced liver fibrosis for cirrhosis in line with NICE's guideline on cirrhosis.

Obviously something in your fibrosis risk score has flagged a need for further investigation and it's good your doctor is referring you on for this. There are 4 stages of fibrosis from F0 (no fibrosis/healthy liver), F1 (mild fibrosis), F2 (Moderate Fibrosis), F3 (Severe Fibrosis often with bridging fibres a.k.a. incomplete cirrhosis) and F4 (cirrhosis). Anything up to F4 (and even early F4) are generally considered reversible perhaps with lifestyle changes, healthy diet and exercise although other factors might be in play depending on what other risk factors you have for the NAFLD (medications for and other contributory conditions such as thyroid problems, diabetes etc.)

The British Liver Trust page on NAFLD goes into the Fibrosis scoring systems and what the 'risk' score might indicate. britishlivertrust.org.uk/in...

Hopefully you don't have to wait too long for your follow up appointments. In the mean time you could examine the BLT page on NAFLD and see if there are changes you can make to your health in the interim.

Best wishes,

Katie

[tinkerbelle65 in reply to AyrshireK]

Thank you so much for your reply Katie, it is very much appreciated. I know I have to change my eating and lifestyle as this is just the latest health problem I have. The trouble is there is so much conflicting info out there, especially about food. Still early days I guess.

[AyrshireK in reply to tinkerbelle65]

This information may be useful to you, its the BLT booklet on 'Treating NAFLD with Healty Diet and Exercise' britishlivertrust.org.uk/wp...

[tinkerbelle65 in reply to AyrshireK]

Thank you, I will have a read and go from there.