Abnormal Liver Function Tests (LFTs)
Liver function tests are one of the most commonly requested ‘routine’ blood tests. The pattern of abnormal constituents of liver blood tests may provide a clue to the underlying diagnosis. Whilst this does not always offer an explanation for the original symptoms, it is important to investigate and diagnose any liver disease at an early stage.
Abnormal Liver Imaging
The liver can be investigated with imaging tests including ultrasound, CT scan or MRI. Any abnormality detected can be further investigated with more sophisticated contrast examination. It may be necessary in some cases to get a liver biopsy (tissue sample) to be certain about an underlying diagnosis.
Alcohol related Liver Disease
Excess alcohol intake is the commonest cause of chronic liver disease. When harmful drinking or alcohol dependence is diagnosed, a thorough assessment of any established liver disease is crucial to determine long term prognosis and monitoring needs. The ongoing management requires a multi-disciplinary team input including hepatology, psychiatry/psycholology, and dietetics support.
Viral Hepatitis B
Chronic Hepatitis B is an emerging problem in the developed countries, through increasing international air travel and migration. Hepatitis B is a virus that can be transmitted through blood or sexual contact. In individuals with no prior exposure to Hepatitis B, it is a preventable condition with a course of vaccination. Chronic Hepatitis B requires life long monitoring and anti-viral treatment in some cases. A specialist medical report may be necessary for immigration to certain countries.
Viral Hepatitis C
Chronic Hepatitis C is a virus that can cause damage to the liver. The liver disease does not manifest any symptom until the late stage. The modes of transmission include past exposure to infected blood/blood products or contaminated injection devices. Blood tests for the type of hepatitis C virus and viral activity, and liver assessment, inform the decision for an antiviral treatment course and prognosis.
Fibroscan (also known as Transient Elastography) is a painless non-invasive alternative test to liver biopsy to evaluate the stage of liver fibrosis.
In this test, a mechanical pulse generated (at the surface of the skin) triggers propagation of an elastic wave (through the liver) whose velocity is measured by ultrasound. The velocity of the wave is governed by the hardness of the environment it crosses, in this case the stiffness of the liver, which directly correlates to the level of fibrosis. The harder the liver, the more severe the underlying fibrosis.
Specialist Endoscopies and more . . .