Alternatives to a liver biopsy?

An occassional drinker, 2-3 drinks about twice a month

Okay, my k owledge through symptoms is through alcohol, but they can often be similar for other things.

Your liver is your energy supply and if you are feeling fatigue, this points to a problem with the liver. The interim remedy, is to eat little and often, no large main meald, but a decent snack mid morning, mid afternoon and shortly before you go to bed. To keep providing energy for the liver, as it appears unable to store it at the moment.

Whilst dark urine, can be associated with too little fluid intake and the kidneys, liver problems produce symptoms such as dark urine. The fact that you have oesophageal varices means that you have portal hypertension of the liver.

Blood work cannot rule cannot rule out liver problems. I have alcoholic cirrhosis and my bloods come back fine, because I no longer drink. The ultrasound has confirmed abnormalities and an ultrasound is the best way to pick these up.

Your doctor/gastro has already picked up that there is an issue and now they want to find out what it is. You need to let them do the endoscopy/biopsy to find out what it is. I know that gastroscopy is not pleasant for many, I had one last year and told them they had better sedate me until I was out cold, otherwise there was no way they were pushing that hose down my neck.

I had the endoscopy which is how they diagnosed the varices.  The liver biopsy is next.  I was hoping for a different way to go but it sounds like the biopsy is a must to obtain the histology.  The idea of it bothers me because of having to be awake for it.  I slept through the endoscopy and was hoping to do the same with the biopsy.  

Ah, no, I couldn't be awake. I had one in hospital and I was anaesthetised because I was a long term inpatient.

Last year, they refused and said either awake or I could be made a bit sleepy with a sedative. So I went, I was lyiny on the table and my actual gastro was doing it, and there was a general nurse and a specialised nurse present.

I just said to him, I am calm now, totally logical and not showing any signs of fear. I said, but when you try to put that pipe down my throat, my gag reflex will kick in. At this point I should say I am over 6'2" and built like a bull. I said, I will probably panic, try to remove the tube from my throat. I said, please don't try to stop me, as I will probably start lashing around and make for the exit, anyway who gets in the way is liable (unintentionally) to get hurt.

At that point, he shouted something at the nurse, which I didn't catch, but I assumed was something like, double the dosage. Because when he pushed the syringe into the cannula I was out like a light and didn't wake until I felt the trolley move and bang the swing doors open.

I'd just tell them you can't do it awake.