Procedure guide · Hepatology and gastroenterology
A liver disease evaluation brings together blood tests, scans and sometimes a biopsy to work out whether the liver is damaged, why and how badly. MedlinePlus notes that liver disease sometimes causes no symptoms. Liver function tests alone usually cannot diagnose a specific disease. That is why a specialist builds the picture from several tests.
What does a liver evaluation involve?
MedlinePlus lists the main causes of liver disease. These are viral hepatitis, drugs, poisons or heavy alcohol use, fatty liver, liver cancer and inherited conditions such as haemochromatosis and Wilson disease. An evaluation aims to find the cause and judge how much scarring, called fibrosis, is present.
Typical parts of an evaluation include:
- Blood tests: MedlinePlus explains that liver function tests measure substances such as ALT, AST, ALP, albumin and bilirubin, and the blood’s clotting time
- Tests for causes, such as hepatitis viruses, as your specialist decides
- Imaging: ultrasound, CT, MRI or MRCP of the abdomen
- Elastography: MedlinePlus describes an ultrasound or MRI test that measures liver stiffness, which can reflect scarring
- Liver biopsy in some cases, when other tests leave questions
Who may benefit from an evaluation?
People with abnormal liver blood tests, a scan showing fatty liver or scarring, known hepatitis, or symptoms such as jaundice or abdominal swelling may be advised to see a liver specialist. MedlinePlus lists symptoms including swelling of the abdomen and legs, easy bruising, changes in stool or urine colour and jaundice. The specialist decides which tests you need.
When transplant is discussed
Some evaluations lead to a discussion about liver transplant. In India a foreign national may receive a living-donor transplant only from a near relative, with the relationship certified and approved by the hospital’s authorisation committee. IndiaMedica never sources donors.
What reports should you send first?
- All liver blood tests you have, with dates, so trends can be seen
- Hepatitis test results and any treatment received
- Ultrasound, CT or MRI reports and image files
- Elastography or FibroScan reports if done
- Any endoscopy reports, especially for varices
- A full list of medicines, supplements and herbal products, and your alcohol history
MedlinePlus notes that liver test results can be affected by other conditions and may be repeated. Expect some tests to be done again in India.
How should you plan the trip?
- Remote review of your existing reports
- Consultation with a hepatologist in India
- Repeat blood tests, imaging and elastography as advised
- Biopsy or endoscopy only if the specialist recommends it
- Results consultation with a written plan
- Home: share the plan with your own doctor for monitoring
MedlinePlus says you may be asked to fast for several hours before elastography. Ask the hospital for preparation instructions for each test in advance. An attendant is useful if a biopsy or endoscopy is planned.
What should you ask the hospital?
- Which tests will you repeat and which can you use from home?
- What do you think is causing my liver problem?
- How much scarring is present and how was that measured?
- Do I need a biopsy, and what does it involve?
- How should my liver be monitored after I return home?
- Will you provide a written summary for my doctor?
IndiaMedica helps you organise reports and questions. The treating hepatologist decides what tests and treatment you need.
Questions people ask
Can liver blood tests alone diagnose my condition?
Usually not. MedlinePlus states that liver function tests alone usually cannot diagnose specific diseases. Abnormal results usually need other tests to find the cause. Your specialist will combine blood tests with scans and history.
What is a FibroScan?
MedlinePlus describes FibroScan as a type of ultrasound elastography. It sends vibrations into the liver and measures how fast they travel. Stiffer tissue, which can reflect scarring, transmits them faster. It can also estimate liver fat. You may be asked to fast beforehand.
Should I bring my herbal remedies and supplements list?
Yes. MedlinePlus lists drugs and poisons among causes of liver disease, and some products can affect the liver. Bring a full list of everything you take, including supplements and herbal products. Your specialist needs this to interpret your tests.
Sources
General information, not medical or legal advice. Rules change: confirm with the official source. Your treating specialist decides on suitability, treatment and length of stay. How we write and check.