Is it the "gold standard"?

[ToughToes]

Hi Folks,

Three weeks ago, I had a gastroscopy and a colonoscopy. The gastrenteroligist said that he saw some changes in the mucosa of my stomach that made him suspect it might be portal gastropathy. Never heard of the term until then, so of course I googled it only to read to my shock and horror that it is commonly caused by cirrhosis. If this is true,it would be remarkable since I only had an abdominal ultrasound in December 2023 and all the report said was that the liver was normal in size and homogeneous in texture, abd that it was consistent with grade one steatosis. No change from previous ultrasounds of June 2021 and January 2020. Also, liver function tests done at the same time were all within the normal range.

My GP says it would be one of the fastest liver deterioration in history for it to have gone from grade 1 mild fatty infiltration to outright cirrhosis in only 6-7 months. Regardless, I has my follow-up with the GI doc yesterday and although he didn't seem overly concerned, he said the only way to say definitively would be to get a fibroscan. I told him to leave it with me, as I'm not sure if I'm mentally prepared in case it's not good news.

First, is this true that I fibroscan will confirm or rule out cirrhosis? Secondly, what is the threshold, or cut-off between a non-cirrhotic and a cirrhosis liver numbers wise?

Thanks again,

Terry

[ToughToes]

Is it just my questions that nobody wants to answer? Stato get a vote of a complex here.

[Pita123 in reply to ToughToes]

For the first question, I don't think it is true. You will probably need further testing. A specialist might need a biopsy or an MRE to evaluate. Best wishes.

[ToughToes in reply to Pita123]

You don't think what is true?

[Pita123 in reply to ToughToes]

"First, is this true that I fibroscan will confirm or rule out cirrhosis?" That is what I responded to. Str8jacket's answer is very helpful.

[ToughToes in reply to Pita123]

Thosbis complicated crap, eh? Some people say this, some people say that. There doesn't seem to be any consistency between doctors, or patients.

[Pita123 in reply to ToughToes]

I think mostly people say the same things. I guess there isn't a definite answer technology yet or other methods to diagnose perfectly. We finally got an approved medication and perhaps more attention is going to the liver now than ever.

[Str8jacket]

You ask if you can get a "definitive" result with Fibroscan. No test, even a biopsy, is 100% definitive. Any test can have false positives or false negatives. For cirrhosis, a Fibroscan, which estimates liver fat and scarring by looking at stiffness, is much more accurate than an ultrasound. It is also quite cheap, fast, and easy to administer.

Magnetic resonance elastography (MRE) is the best imaging test, but is not widely available and is very expensive. A liver biopsy is still considered the gold standard for diagnosis, but has its own risks. And even a biopsy can be inaccurate, as it takes only a tiny sample of the liver, and evaluation is dependent on how representative the sample is and the pathologist's expertise in reviewing it.

If you feel fine, don't panic. Do everything you can to keep your liver (and everything else) healthy, with a good diet and lots of exercise. Even if you were to have cirrhosis, if you take proper steps you can live well with it for a long time. Most people with cirrhosis don't even know they have it.

[ToughToes in reply to Str8jacket]

Ok, thanks for all the information.