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Old 01-21-2013, 12:47 PM   #1
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LaMaestra2015 HB User
Liver Biopsy - really necessary???

About 9 yrs ago I had elevated enzymes and I had a liver biopsy. They found that I had fibrosis and scarring (between stage 2-3) and that I had NASH. I was overweight back then and since then I have lost 60 lbs and have kept them off for the last 7 years. I am not at my ideal weight (maybe 15 lbs over) but I work-out, don't drink and basically eat healthy.

My liver enzymes are normal but a routine US shows increased fat in the liver. The liver specialist wants to do a liver biopsy to see where I stand at this time. I have mixed feelings, should I wait until something is wrong or should I check and see???

They are going to performed a transvascular liver biopsy..Any advice..

 
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Old 01-21-2013, 06:35 PM   #2
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BillinSD HB UserBillinSD HB UserBillinSD HB UserBillinSD HB UserBillinSD HB UserBillinSD HB UserBillinSD HB UserBillinSD HB UserBillinSD HB UserBillinSD HB User
Re: Liver Biopsy - really necessary???

To biopsy or not to biopsy is an interesting question...

There's no real therapeutic value, and there always is a very real risk (however small) of complications. Doctors like to document things, and some patients want to know exactly where they stand also. Ask your doc "would my treatment change if my condition has progressed?"

Sometimes when fibrosis is progressing, this may indicate a need for endoscopy to look for rectal or esophageal varices that may need banding, but ultrasound should also show an enlarged portal vein or slowing of blood flow (doppler) when this is occurring (portal hypertension).

Fibrosis is also not evenly distributed in the liver and if your biopsy is taken from a dense patch of tissue, it might give a false impression your disease is progressing when it may not be. The opposite can also occur.

I drank for many years and when I started getting early warnings of liver disease I cleaned up my act and started taking care of myself. My labs are now good, my ultrasound shows mildly echogenic with no gross abnormalities, and I'm feeling fine.

I don't really want to know if I'm stage 2-3 or 3-4... I'm doing everything I can to keep my liver happy, and that's the best I can do. If my labs start going off or I start feeling bad or had a more ominous ultrasound, my feelings about biopsy might change; but the risk/reward of biopsy doesn't have a lot to offer me (personally) at this point.

Then again, if I had a specialist I trusted, and he really thought it was important to do this at this point in time, I'd probably consider his advice carefully if he could explain to me why or how it would actually change or help my case.

Last edited by BillinSD; 01-21-2013 at 06:50 PM. Reason: addition

 
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