Why have a liver biopsy?

[kaywire]

My liver "specialist" says he'd like me to have a liver biopsy. I was diagnosed with PBC ten years ago and have no symptoms apart from achy bones. I understand there are some risks with this procedure. What is the point of having this from the patient's point of view? I don't want to know what stage of the disease I'm in - apart from helping with this guy's statistics I can't see the point. Comments please!

[Pandemonium]

Just say 'no' if you don't want one.

Are you responding to Urso? If not, SOMETIMES specialists will want to biopsy to check for AIH crossover with PBC.

[Hidden]

Hello kaywire.

Well from my point of view I can't see either why one should have a liver biopsy if they have been established to have PBC.

I was diagnosed with symptons (itching as the fatigue wasn't really getting to me and 2yrs on from Urso it is pretty non-existent these days) and then after continuing abnormal and deranged LFTs over several mths., I had the AMA blood which was positive.

My GP did mention to me at some point that liver biopsy would prob be undertaken so I argued with him at the time stating for me it would be and end of the line thing after other avenues were exhausted. I had stumbled across PBC but never mentioned it to medics but I did know that an AMA could show if one had PBC (and in event that was negative for me then I would have considered the biopsy).

You don't have to have a biopsy regardless of what a consultant says to you. A lot of contributors on here might disagree with me but in my way of thinking, medical professionals are curious and like to find out other things and who else than someone with a puzzling condition as PBC still is. It'll be run of the mill to them but not for the patient who is having one and yes you are right there are risks involved tho' it is stated 'quite minimal'.

Personally I do not want to know any stages and in these days I am pretty much 100% certain that scans and bloods can show a pretty much accurate picture along with any developing symptons as to how one is getting by with PBC.

I think with any PBC patient as time passes the medics start to wonder if this is happening (ie noticed a lot of you have been for DEXA scans) and then may request you have this test and that test.

I still think with a biopsy if one has PBC and the liver is perhaps a bit inflamed due to the bile ducts being damaged then having one means that the area that the biopsy was taken has to heal over thus causing in my opinion more stress on us. Also biopsies aren't accurate in a sense as the area the biopsy is taken might not show how the rest of the liver is.

Has been mentioned on here about fibroscans recently. I'd enquire about one of these non-evasive scans instead of considering a biopsy and see what the consultant who wanted to do a biopsy says.

[Trista]

I had a liver biopsy last week to confirm what stage I'm at and that was because having been diagnosed four weeks ago, i'm only 25, my scan already showed scarring and I have quite a few more symptoms besides the fatigue and itching. The procedure was really quick and easy for me. The dr who did it was an expert at doing then so I had full trust. You get pain for about an hour afterwards but they give you relief and monitor you for about six hours. I had about two days of pain but that was due to other medical conditions that make me more susceptible to pain that where someone could get pinched and it hurts for a couple of seconds, I hurt for a couple of minutes etc. After ten years, the only reason I would have it done was if you were on medications and your LFT's haven't improved or have increased... Talk about it with your doctor, ask why, what are they hoping to achieve from it, get all the facts and then make YOUR decision. Good Luck!

[littlemo]

Hi there do you live in the U.K. if so ask your consultant about having a fibroscan as far as I know this is taking over from biopsies. It is a painless procedure bit like an ultrasound scan( if you have ever had one of those) and it shows up the degree of scarring (or fibrosis or worst case scenario cirrhosis in the liver). The test only takes about ten-fifteen mins and the results are instant as opposed to waiting longer on liver biopsy results. Unfortunately though, not all hospitals have them which is why ur consultant may be wanting you to have a biopsy. If he/she wants it if your condition is gettting worse going by his or her observation of you via bloods or other tests results (scans etc) then I would go for the biopsy if I were you, but you do have the right to refuse ,but in general doctors do not like to put patients through invasive procedures unless really necessary for the good of the patient. Thats my opinion hope it helps. Best of luck. x

[kaywire in reply to littlemo]

Thank you all for your kind answers. They've given me plenty to think about. I will ask about a fibroscan. Thanks. xx