What tests will I need?
A doctor may suspect that you have liver problems from your symptoms and from a physical examination, for example, they may detect that your liver is enlarged, or that you are retaining fluid. They may especially think of liver problems as a cause of your symptoms if you have a history of heavy alcohol drinking. Some tests may be done:
- Blood tests may show abnormal liver function. There are a number of liver function tests (LFT's) that look at levels of various chemicals in the liver. If the liver is damaged or becomes inflamed then the levels of these rise and can be detected on a blood test as they are released into the bloodstream. Even though a number of different LFTs are tested, you only need to give one blood sample for all of them.
- A blood test to check how well your blood clots. Helping your blood to clot is one of the functions of the liver, and you may be at higher risk of bleeding if your liver is damaged.
- A blood test for anaemia. People with alcohol problems can be deficient in a vitamin called vitamin B12, which can lead to anaemia
- An ultrasound scan may show that you have a damaged liver. This painless test is the same type as pregnant women have when their baby is being checked. Some lubricating jelly is placed on the skin of the tummy over the liver, and a handheld ultrasound scanner is moved across the skin. This shows an image of the liver on a monitor and liver damage or enlargement can be seen.
- To confirm the diagnosis, a small sample (biopsy) of the liver may be taken to be looked at under the microscope. The 'scarring' of the liver caused by liver damage (cirrhosis), or the typical features of liver cells with alcoholic hepatitis can be seen on a biopsy sample. This is usually done by a liver specialist and involves freezing an area of the skin with a local anaesthetic above the liver and pushing a small needle into the liver to obtain a sample.
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- House of Commons Science and Technology Committee - Alcohol Guidelines (Eleventh Report); UK Parliament, December 2011
- Schutze M, Boeing H, Pischon T, et al; Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study. BMJ. 2011 Apr 7 342:d1584. doi: 10.1136/bmj.d1584.
- I J Beckingham and S D Ryder; ABC of diseases of liver, pancreas, and biliary system: Investigation of liver and biliary disease. BMJ 2001 322:33-36.
- The Government's Alcohol Strategy (proposals to cut 'binge drinking', alcohol-fuelled violence, and number of people drinking to damaging levels); HM Government, 2012
- Antenatal care for uncomplicated pregnancies; NICE Clinical Guideline (March 2008, updated 2017)
- UK Chief Medical Officers' Alcohol Guidelines Review, Summary of the proposed new guidelines; Dept of Health, January 2016
- Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence; NICE Clinical Guideline (February 2011)
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