Welcome back to the fourth and final installment about my liver biopsy experience! If you missed Part 1 (all about the actual procedure), Part 2 (preparation and recovery), or Part 3 (everything about pain management) definitely check them out!
Here’s the table of contents so you can go straight to the parts you’re most interested in. Just please remember, this post is not medical advice! I’m speaking straight from my experience and my own research, and you should follow the instructions from your medical team.
Table of Contents
- Why People Get Liver Biopsies
- If other non-invasive procedures have been inconclusive
- If you have an enlarged liver
- If you’re jaundiced
- If you have abnormal liver numbers
- To determine a treatment plan or to see how well your treatment plan is working
- To determine what type of liver disease you have AND what stage of disease
- To monitor you after a liver transplant
- What Can a Biopsy Tell You About Your Liver?
- In Conclusion
Why People Get Liver Biopsies
There are many different reasons your gastroenterologist or hepatologist might order a liver biopsy, but here are some of the more common reasons:
If other non-invasive procedures have been inconclusive
Most, if not all, GIs and hepatologists will start investigating your liver with non-invasive procedures. I had multiple procedures since November 2017, and the first few came back with inconclusive results. Only after I had a few abnormal results did my hepatologist agree to do the invasive liver biopsy:
I’ve done two MRCPs (both came back inconclusive)
I’ve done a FibroSpect blood test (which was also inconclusive)
I’ve done a liver ultrasound (which suggested fatty deposits in my liver)
I’ve done a FibroScan (which suggested possible stage 1 fibrosis)
If you have an enlarged liver
An enlarged liver could be a sign of cirrhosis, tumors, an obstruction, or a liver disease. Typically, an invasive procedure like the liver biopsy is preferred at this point, as it tends to give the most accurate result.
If you’re jaundiced
This is when bilirubin, a waste material, seeps into your blood, causing a person’s skin and eyes to turn yellow. Ultimately, this means that your liver isn’t fully functioning properly because one of its main jobs is to keep waste material out of your blood.
If you have abnormal liver numbers
High liver numbers, also known as Liver Function Tests (LFTs) can be a warning sign of liver disease.
The most common LFTs that are monitored are ALT, AST, GGT, and Sed Rate (also known as ESR). There are of course more, but these are the main ones I have monitored regularly.
My GI noticed a spike in these liver numbers in the summer of 2017. They only spiked that one time, but it was enough of a warning sign for her to investigate further. And I’m glad she did!
To determine a treatment plan or to see how well your treatment plan is working
A liver biopsy may become a regular procedure to keep tabs on your current treatment plan. It’s also a great method to help you and your medical team figure out a treatment plan.
To determine what type of liver disease you have AND what stage of disease
Some potential diseases a biopsy can help diagnose include:
- Primary Sclerosing Cholangitis (PSC)
- Primary Biliary Cholangitis (PBC)
- Autoimmune hepatitis
- Chronic hepatitis B or C
- Non-alcoholic Fatty Liver Disease (NAFLD)
To monitor you after a liver transplant
People who have received a liver transplant—shout out to you registered organ donors!—need to be closely monitored to ensure the new liver is functioning properly.
What Can a Biopsy Tell You About Your Liver?
Just like many procedures, liver biopsies aren’t guaranteed to be 100% accurate. However, they can be extremely helpful in identifying:
Inflammation can be found in the liver or in/around the bile ducts. The presence of active inflammation is an important discovery for you and your medical team
Fibrosis in your liver or bile ducts
Fibrosis is also known as scarring, or scar tissue. When your liver or bile ducts become scar tissue, they become much stiffer, and therefore, less effective. Fibrosis can lead to cirrhosis
Cirrhosis, or chronic liver damage
This is when the scar tissue of fibrosis destroys the liver’s ability to function. Enough cirrhosis can lead to liver failure
Liver biopsies are helpful procedures, but they sometimes can’t give an official diagnosis. For example, it’s still not 100% beyond a shadow of a doubt that I have PSC (but it is about 95% certain. I will explain in an upcoming blog post).
So, ultimately, talk with your medical team. See if there are any other non-invasive procedures you can do. Chat about the pros, cons, risks, and benefits of doing a liver biopsy.
If you and your medical team end up choosing to proceed with a liver biopsy, I hope my blog series has helped prepare you for the experience 😊
Any questions about liver biopsies and what they can tell you? Please don’t hesitate to reach out in the comments or on my social media!
Please remember: I am not a medical professional. The information in this blog post (and anywhere on my website and its affiliated social media channels) is simply me sharing my story, experience, and research. It does not take the place of medical advice from a licensed medical professional. Talk with your medical team before implementing any listed takeaways or anything else 🙂