Biopsy, Cause, Activity, and Stage

[Kokomodo]

My hepatologist asserts that a biopsy is the only confirming (as opposed to predictive) test for cirrhosis. A biopsy will provide an estimate of the stage. However, as the cause of my cirrhosis is unknown, I am particularly interested in knowing the activity. What tests should I consider to evaluate the activity level? Are such tests relevant or informative once the liver is actually considered cirrhotic?

[kensimmons]

Before doing a biopsy any doctor will do a large series of blood tests to see if you even need a biopsy. They will want to see the stuff that is talked about often on these message board (AST, ALT, some others) and some rarer tests for rarer causes of liver problems (Anti Nuclear Antibody test for example - don't worry, it's just a blood in test tube test and can show possible Autoimmune Hepatitis, which is rare). Until then you are getting way ahead of yourself about a biopsy.

Keep in mind I am not a doctor, always listen to a doctor over someone like me on a message board.

[Kokomodo in reply to kensimmons]

Ken, thank you for the guidance. I glossed over a lot of background, assuming it would be evident from "my hepatologist." I might have qualified that with "my laconic hepatologist" but I'm looking to cast a wide net for information on tests that provide an indication of activity (i.e., ongoing advancement of fibrosis or liver degradation.)

Is activity level a common topic of discussion (between patients and their doctors) or is stage the predominant concern?

I ask because the cause of my cirrhosis is unclear, and I'm trying to understand what responses (e.g., lifestyle change) might prevent further degradation (decrease activity.)

[kensimmons in reply to Kokomodo]

I think the tips are universal, eat a good healthy meal plan, lose weight (if applicable), exercise and listen to your doctor. And obviously no smoking and drinking until you find out what's what.

I think stage is really what is concentrated upon, not so much activity level, but that's a guess from me, someone who is NOT a doctor or medical person.

Actually, first they will probably try to find out what is causing the problem. It could be a heart issue or an autoimmune issue or a drinking issue or a virus or something different. Those would presumably be treated with different medicines and procedures.

[Catwalker]

I don't know which is of primary importance either but after having a liver biopsy, my hepatologist was able to determine stage of my fibrosis (stage 2, moderate) and also that my liver was still showing signs of inflammation progressing. I am not sure whether my experience is useful information ir not but I hope it is. Also, the liver biopsy was very uneventful (except for the diagnosis, which I thought and hoped would be a fatty liver as I was told I had on ultrasound 14 years ago. My internal primary doctor at that time just had his secretary call and tell me I had a fatty liver. I asked what yo do about it and she told me that was all he said (to call and tell me) so, in my ignorance, I thought if it was important, he would have let me know. I then much later saw a television show showing a fatty liver and one that was not fatty, and decided to lose weight. I lost 40 lbs but it progressed to fibrosis anyway. I'm eating much better and exercising now, attempting to keep it from progressing. It is my understanding that I can improve the fatty liver but not the fibrosis. I am forcing down two 8 ounce cups of iced coffee diluted with low fat/low calorie high protein shake, hoping that will help in addition to other dietary changes and exercise. Good luck to you and please keep us all posted!

[Kokomodo in reply to Catwalker]

Catwalker, thank you for your input. That is helpful.