Well formerly the liver biopsy was considered the gold standard. It involves going to a hospital and undergoing conscious sedation while a large needle while maybe also guided by ultrasound is inserted into the right side either between the ribs or from the stomach area into the liver to remove a sample of liver. After you will have to lie quietly for a couple of hours to be sure there is no internal bleeding after which you will need a ride home and remain quiet for the rest of the day with no heavy lifting for a couple of days. The liver biopsy is subject to sampling error depending on where the piece of liver tissue is removed from.
The new Fibroscan is replacing the liver biopsy in many practices. It is more accurate in the more (F4) or less (F1) ranges of liver damage and less accurate in mid ranges of damage. The Fibroscan is usually found at more advanced liver speciality centers and not at a regular doctor’s office. My hepatologist at the University of Washington Seattle Liver center has a Fibroscan machine. The test can be done in office with no down time. It is similar to an ultrasound except the device produces a sort of thump that allows the device to estimate liver stiffness. The result is a number which is compared to a scale and depending on the cause of liver damage can estimate fibrosis score.
The fibrosure test is a blood test that can also estimate fibrosis score. Similar errors to the Fibroscan exist in that the test is also less accurate for mid range levels of damage.
Basically, all three are good tests but all have their own limitations as far as accuracy and differing levels of invasiveness and risk for the patient.
But for any of these tests you would need to have a doctor to request the test. A liver biopsy is an invasive medical procedure and would cost your insurance several thousand dollars.
From your previous posts if I recall correctly your doctor feels your liver is fine based on your lab tests and physical examination and would not tecommend liver damage testing.
I recall you saying your doctor did say you have ulcers caused by Helicobacter pylori (H. pylori) bacteria and recommended a course of antibiotics and acid reducing meds this being the standard protocol for this condition.
Have you done that treatment and how is your ulcer doing now?
Have you had a liver biopsy, Fibroscan, or fibrosure test?
What was your fibrosis score?
From healthline
“What are the stages of liver fibrosis?
There are several different scales of liver fibrosis staging, where a doctor determines the degree of liver damage. Since staging can be subjective, each scale has its own limitations. One doctor may think a liver is slightly more scarred than another. However, doctors will usually assign a stage to liver fibrosis because it helps the patient and other doctors understand the degree to which a person’s liver is affected.
One of the more popular scoring systems is the METAVIR scoring system. This system assigns a score for “activity” or the prediction of how fibrosis is progressing, and for the fibrosis level itself. Doctors can usually assign this score only after taking a biopsy or tissue sample of a piece of the liver. The activity grades range from A0 to A3:
A0: no activity
A1: mild activity
A2: moderate activity
A3: severe activity
The fibrosis stages range from F0 to F4:
F0: no fibrosis
F1: portal fibrosis without septa
F2: portal fibrosis with few septa
F3: numerous septa without cirrhosis
F4: cirrhosis”
If you are referring to F1 fibrosis this is not cirrhosis. Cirrhosis is defined as F4 scarring. Cirrhosis is further defined as compensated or decompensated.
For those with F4 scarring (Cirrhosis) there is about a 50% chance of reduction of scarring. This would depend on severity of liver disease and duration of being F4 before taking action to prevent further liver damage like curing hep c, stopping excessive alcohol consumption or improving their health to lose weight and thus treat their fatty liver disease.
However, if the cause was hep c infectionper the AASLD (American Association for the Study of Liver Diseases) The recommendation for those who at treatment were F3 fibrosis or F4 cirrhosis they will still need likely lifetime follow up with their hepatologist to monitor for early signs of liver cancer. This is because even though their liver disease should not worsen after cure of hep c assuming they have no other complicating risks like NAFLD people with fibrosis scores of F3 and F4 while their risk of HCC is reduced they will still be at a higher risk of HCC than those with lower fibrosis scores.
As an example per the AASLD patients cured of hep c with fibrosis scores of F2 or lower do not require any any adfitional follow up post treatment and can expect improvement of their liver with time.