Endoscopy & Doppler Ultrasound Results

[Phil64]

Just received my endoscopy and ultrasound results today. Looks relatively good other then some findings I do not understand "Mirco Nodular Contours? My LFTs are now normal except GGT which is Stabilizing (432 to 129) from suspected ALD. I am currently sober for the past 4 months.

Endoscopy: No Ulcers, Tumours/Cancer, Varices or Ascities.

Ultrasound: Aorta, pancreas, biliary tract, gall bladder and normal kidney. The spleen has no focal lesion, it is normal dimension.

The liver shows to have micro-nodular contours suggestive of chronic hepatopathy. No suspicious focal lesion. Doppler flow no anomaly on the portal vein and hepatic veins.

in summary: Signs in favor of chronic hepatopathy. No sign of portal hypertension. No focal lesions in the hepatic parenchyma.

I do not see any reference to Echo Texture, Fibrosis or Cirrhosis? What do you make of these results? Thanks.

[AyrshireK]

Phil, I sent you a fairly detailed reply to this same post when you put it up on British Liver Trust Health Unlocked page.

[Phil64 in reply to AyrshireK]

Sorry, I did not see it. Maybe because I do not know my way around this site yet? Can you re-post it. Thanks a Million, much appreciated.

[AyrshireK in reply to Phil64]

I would really leave the full interpretation of your results to a doctor as whilst the term 'coarse echo texture' hasn't been used they have said chronic hepatopathy which would translate as:- chronic = persistant or long lasting disease

hepatopathy = A generic term for any disease of the liver

mi·cro·nod·u·lar

Characterized by the presence of minute nodules; denoting a somewhat coarser appearance than that of a granular tissue or substance.

Only your doctor can confirm the state of you liver but it does look like you have a coarse texture thing going on caused by a long lived liver condition.

Good news though in the normal portal veinous flow so no portal hypertension, no enlarged spleen, no lesions of any type. Looks like they've caught your condition before the major symptoms begin, it might be that it's just fibrosis or early cirrhosis and you can perhaps turn things around.

All the best, Katie

[Phil64]

Thanks Katie, that has been very helpful and gives some relief. I have another question concerning Fib-4, if you do not mind?

29 Sep: 3.62; 31 Oct: 2.27; 27 Nov: 1.7; and 15 Dec: 1.7.

(Fib-4 >1.45 suggest Fibrosis, and > 4 Cirrhosis). Do my past results suggest damage already done? What does the lowering of my scores suggests? I have made considerable life changes in the past 4 months. The only lingering results of my LFTs is that of my GGT (129 from 627-432-236-161) in results. All other results are in range.

Once again, thank you. You are awesome

[AyrshireK in reply to Phil64]

I don't really know what the scores are you mention that you had repeatedly done but they are going down so it looks like your doing the right things and going the right way. Also your GGT going down is all good too.

It used to be thought that cirrhosis was irreversible but thinking on that has changed and it's possible you are reversing some of the damage done by adopting your healthier and booze free lifestyle. Well done you, keep it up.

Katie

[Phil64 in reply to AyrshireK]

I have had a Fibroscan at my own request which resulted in a 22 KPa last September which triggered all of this. My BMI is down to 30 from 31. I assume there is no more inflammation as all my LFTs are now in range other than GGT which is lowering. I have no other medical conditions other than elevated cholesterol. I am scheduled for an other Fibroscan on the 19th. I hope there was an over estimation in the results due to my recklessness. I am anxious and scared. I hopping I kicked back a few points down to at least F1-F2?

[Phil64]

Thanks Chris for your reply. I do not know what happened to it as I cannot see it anymore. If you can re-post it? Here is my reply.

Thanks Chris. I have made some significant lifestyle changes in the past 4 months. I have had a Fibroscan at my own request which resulted in a 22 KPa last September which triggered all of this. My BMI is down to 30 from 31. I assume there is no more inflammation as all my LFTs are now in range other than GGT of 129 which is lowering. I have no other medical conditions other than elevated cholesterol. I am so happy to have found this wonderful site. Thanks.

[Kristian in reply to Phil64]

Sorry Phil, that was my fault. I deleted the initial one as i was repeating to much of what Katie had already said.

Basically, it looks like you've probably done a bit of damage with the micronodular contours appearing. Fortunately with everything else looking ok you've so far managed to stave off any secondary issues that can come with liver damage.

Its probably worth speaking to your doctor about what your results mean for you as I can't be sure whether the micronodular contouring was a result of severe fibrosis or whether it had got to cirrhosis. It is possible to reverse fibrosis and, i believe, even the early stages of cirrhosis now. It is though very possible to completely stop the progression of either.

The fact that your other results are all improving, show that what you are currently doing is having the desired effect. So even if you do have a bit of cirrhosis, you are doing the right thing to stop it progressing and stop it becoming any form of problem.

It will be interesting to see what your next fibroscan result will be. Having a BMI over 30 can apparently impact on the result, giving a false high. Although i believe technology may have caught up with that problem now. If you have stopped drinking and you've reduced your BMI then your Fib-4 score should come down as both your ALT and AST will reduce. There was another score that also took BMI in to account too.

Basically, keep doing what your doing. You've had a bit of an insight that drinking and being a bit on the large side was having quite a damaging effect on your liver and it will do again. So get yourself down to a healthy weight for you and keep the drinking right down and see what happens. It may be that your doctor will advise you to stop drinking completely. In fact that's that's probably very likely as you've already shown signs of having severe fibrosis.

[Phil64 in reply to Kristian]

Thanks Chris, one more question if I may since you mentioned FIB-4? The on line calculator from my LFTs results are:

29 Sep: 3.62; 31 Oct: 2.27; 27 Nov: 1.7; and 15 Dec: 1.7.

(Fib-4 >1.45 suggest Fibrosis, and > 4 Cirrhosis). Do my past results suggest damage already done? What does the lowering of my scores suggests? Healing or Halted Progression to a slow crawl?

Once again, thank you for your patience. You are great.

[Kristian]

Unfortunately i just don't know. I don't think i've ever had a FiB-4 score done and i haven't really looked into its limitations. I have though read that looking at trends in score is a useful indication of disease activity/progression. So if yours are going down i suspect this is a good thing. Really though, i suspect only your doctor will be able to give you firm advice on that.

[idyllic420]

Hi Phil..How are you holding up these days?