Liver Disease staging/Fibroscan
What is a Fibroscan?
• This is a bedside examination which is used to assess liver stiffness (or scarring), and fat content of your liver
• It is a painless and non-invasive investigation, and a reliable substitute for liver biopsy in many cases
• The result is immediate; it shows whether your liver is normal or scarred, and can be repeated in time to monitor your liver condition
Before the procedure:
• Wear comfortable clothes that allow access to the right side of your rib cage
• You should be fasting for at least 3 hours before your examination. During this time you can take clear fluids only
During the procedure:
• The examination is carried out by a trained operator (doctor, nurse or technician)
• You will lie on your back with your right arm above your head
• You will cross your right leg over your left to help open your rib spaces.
• The operator will apply gel to the skin in the area over the liver and slide a probe around between the rib spaces until the liver is located
• When the operator is satisfied that 10 reliable measurements have been achieved in the same area, the test is complete. This can take between 2 and 20 minutes
Does it hurt?
• No. Fibroscan is painless. You may feel a slight vibration from the probe as the measurements are taken
After the procedure:
When will I get the results?
• The operator may be able to give you instant feedback following the examination if qualified to do so and recommend any necessary lifestyle changes
• A Hepatologist or Gastroenterologist will review the result in conjunction with relevant information such as blood tests and ultrasound, and overall health, to determine the stage of your liver disease, and initiate the appropriate management and follow up
What are the stages of Fibrosis?
• Fibrosis (scarring) is categorised in stages 4 stages (Metavir stage 0 – 4)
• 0 -1 being little or no fibrosis, and 4 being cirrhosis (advanced liver disease)
What causes Liver Cirrhosis ?
Any condition which causes ongoing inflammation of the liver can cause cirrhosis. Liver disease is a silent disease which often causes no symptoms until it is well established however the 3 most causes common are:
(1) Fatty liver-related: ie NAFLD/ MAFLD and NASH. These conditions are mainly associated with carrying increased weight, particularly in the central abdominal area. This leads to a build up of fat in the liver where it is stored (called liver steatosis). Over time, increased liver fat causes inflammation which leads to scarring/fibrosis and eventually cirrhosis.
(2) Alcohol-related Liver Disease: over-consumption of alcohol over a long period of time leads to inflammation and progression of fibrosis to cirrhosis.
(3) Viral hepatitis (Hepatitis B or Hepatitis C). These blood-borne viruses if undiagnosed and left untreated inflame the liver cells and cause fibrosis and cirrhosis.
The risk of developing cirrhosis from any of these causes increases greatly if more than one cause is present.
Early diagnosis of liver disease is crucial in order to prevent cirrhosis and the associated complications.
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