Liver Fibrosis: Treatment Options and Testing in Taiwan

Q: Liver Fibrosis: Treatment Options and Testing in Taiwan

Hello： The causes of liver fibrosis are not limited to hepatitis B, hepatitis C, and alcohol; there are many other different causes. <br>Fibroscan is a more advanced ultrasound scan that can quantify the degree of fibrosis, but it cannot diagnose the underlying cause. <br>Typical

Liver issues?

Hello doctor, I had an abdominal ultrasound that showed liver fibrosis and an enlarged spleen, but I do not have hepatitis B or C and I do not drink alcohol.
What treatment should I pursue? Additionally, do I need to go to Linkou Chang Gung Memorial Hospital for a self-paid liver elastography test? Thank you.

Ms. Li, 40~49 year old female. Ask Date: 2015/12/25

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: The causes of liver fibrosis are not limited to hepatitis B, hepatitis C, and alcohol; there are many other different causes.
Fibroscan is a more advanced ultrasound scan that can quantify the degree of fibrosis, but it cannot diagnose the underlying cause.
Typically, fibrosis is associated with splenomegaly, and in general, this may indicate the presence of cirrhosis.
At this point, there are additional indicators that can support the diagnosis of cirrhosis, such as the diameter of the portal vein and splenic vein observed on ultrasound, as well as possible mild thrombocytopenia.
If these phenomena are not present, one cannot conclude that cirrhosis is present, or that fibrosis and splenomegaly are unrelated.
It is recommended to consult a hematologist to determine whether the splenomegaly is solely caused by liver issues.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2015/12/25

More Info

Liver fibrosis is a progressive condition characterized by the accumulation of extracellular matrix proteins, which can lead to cirrhosis and liver failure if left untreated. Understanding the underlying causes and treatment options is crucial for managing this condition effectively. In your case, the absence of hepatitis B and C infections and a history of alcohol consumption suggests that other factors may be contributing to your liver fibrosis.

Causes of Liver Fibrosis
Liver fibrosis can result from various factors, including:
1. Non-Alcoholic Fatty Liver Disease (NAFLD): This is one of the most common causes of liver fibrosis, especially in individuals who are overweight or have metabolic syndrome.

2. Autoimmune Hepatitis: This condition occurs when the immune system attacks liver cells, leading to inflammation and fibrosis.

3. Chronic Viral Hepatitis: While you mentioned not having hepatitis B or C, it's important to rule out other viral infections.

4. Medications and Toxins: Certain medications and environmental toxins can also lead to liver damage and fibrosis.

5. Genetic Disorders: Conditions such as hemochromatosis or Wilson's disease can cause liver damage and fibrosis.

Diagnosis and Monitoring
To assess the extent of liver fibrosis, various diagnostic tools are available:
1. Liver Biopsy: This is the gold standard for diagnosing liver fibrosis but is invasive and carries some risks.

2. FibroScan (Transient Elastography): This non-invasive test uses ultrasound technology to measure liver stiffness, which correlates with the degree of fibrosis. It is a preferred option for many patients due to its safety and ease of use.

3. Blood Tests: Certain blood markers can help assess liver function and the degree of fibrosis.

In Taiwan, facilities like Chang Gung Memorial Hospital in Linkou offer FibroScan services. It's advisable to consult with a hepatologist or a gastroenterologist who can guide you through the testing process and interpret the results accurately.

Treatment Options
The treatment for liver fibrosis primarily focuses on addressing the underlying cause:
1. Lifestyle Modifications: If NAFLD is suspected, weight loss through diet and exercise can significantly improve liver health and reduce fibrosis.

2. Medications: Depending on the underlying cause, medications may be prescribed. For instance, if autoimmune hepatitis is diagnosed, corticosteroids or immunosuppressants may be necessary.

3. Regular Monitoring: Regular follow-ups with your healthcare provider are essential to monitor liver function and fibrosis progression.

4. Avoiding Alcohol and Toxins: Since alcohol can exacerbate liver damage, it's crucial to avoid it entirely. Additionally, be cautious with medications that can harm the liver.

Conclusion
In summary, while liver fibrosis can be concerning, understanding its causes and treatment options can help manage the condition effectively. Given your situation, it would be beneficial to undergo a FibroScan at a facility like Chang Gung Memorial Hospital to assess the extent of fibrosis. Following that, working closely with a healthcare provider to develop a personalized treatment plan based on the results and any underlying conditions is essential. Regular monitoring and lifestyle changes can significantly impact your liver health and overall well-being.

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