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Biopsy results
Got results back today. It showed hcv had gotten worse. Liver had a little scaring. Going to start treatment soon. Gastro. doc. said I would have to have a colonoscopy and a light run down throat in stomach look at veins make sure no varicose veins. He said medicine was strong and could cause bleeding with enlarged spleen. Is this the proper procedure.
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I read your comment, and I am to undergo an MRI on Oct 1st to check and see if my liver is in stage 4. I was told it is a very trustworthy source. I actually did not want to ingest iodine for the CT Scan, so I asked for an MRI. The MRI is going to cost more to take, but it doesn't shoot radiation through my body either like a CT Scan. So you were told an MRI cannot help?
"I had a x ray imaging done on liver showed no signs of fibrous on the surface of liver. "
Fibrosis is not diagnosed using "a x-ray", CT scan or MRI. Only a biopsy can determine the degree of fibrosis. By the way it was probably a CT scan which uses x rays but is much more than that. Where digital geometry processing is used to generate a three-dimensional image from a series of two-dimensional X-ray images.
Hematologist? A hematologist is a doctor who studies blood, the blood-forming organs, and blood diseases. No. This is not who you should be seeing.
You want to see a "hepatologist". A specialist in diagnosing and treating liver disease. Usually this person is a board certified gastroenterologist with a clinical and research focus in liver disease.
Having a low platelet count can be the first sign of cirrhosis if you are otherwise healthy. A hepatologist will know what further testing you will need to have to diagnose the extent of your liver disease.
Good luck.
Hector
Fibrosis is not diagnosed using "a x-ray", CT scan or MRI. Only a biopsy can determine the degree of fibrosis. By the way it was probably a CT scan which uses x rays but is much more than that. Where digital geometry processing is used to generate a three-dimensional image from a series of two-dimensional X-ray images.
Hematologist? A hematologist is a doctor who studies blood, the blood-forming organs, and blood diseases. No. This is not who you should be seeing.
You want to see a "hepatologist". A specialist in diagnosing and treating liver disease. Usually this person is a board certified gastroenterologist with a clinical and research focus in liver disease.
Having a low platelet count can be the first sign of cirrhosis if you are otherwise healthy. A hepatologist will know what further testing you will need to have to diagnose the extent of your liver disease.
Good luck.
Hector
Blood work was low platles should have been 150,000 to 400,000 right they were only 48,000.
A liver specialist is the usually the best choice if you are looking for someone to manage hcv or cirrhosis. Some GI docs are not knowledgeable about how to treat either condition, so a hepatologist may be the right choice for you... did the GI order the endoscopy for check for varices? That should be done if you have an enlarged spleen. Usually a hematologist may be recommended if you have blood abnormalities... did you have abnormal bloodwork?
As you go through this process of getting yourself good care, try to get copies of all your reports -- the x-rays, the tests that showed scarring, your lab results if you are asked to do bloodwork -- all of this information will help as you "shop" for the right doctor. Also, if you have copies of lab reports, many people here can help you better if you have your results as exactly stated on reports. Hope that helps. ~eureka
As you go through this process of getting yourself good care, try to get copies of all your reports -- the x-rays, the tests that showed scarring, your lab results if you are asked to do bloodwork -- all of this information will help as you "shop" for the right doctor. Also, if you have copies of lab reports, many people here can help you better if you have your results as exactly stated on reports. Hope that helps. ~eureka
I had a x ray imaging done on liver showed no signs of fibrous on the surface of liver. This GI doc. said he could not give me no meds, to come back in 12 months. So I went to another GI Doc. he sounded a little unsure about the problem. But this time I will see a Hematologist. Liver specialist. What do you think am I right.
"Metavir Grading for Liver Biopsy Results
The Metavir grading system uses two standardized numbers: one to indicate degree of inflammation (tissue swelling and irritation) and the other the degree of fibrosis (tissue scarring due to prolonged inflammation).
A 4-point scale is used in grading the degree of liver inflammation or histological activity:
* A0= no inflammation
* A1= mild inflammation
* A2= moderate inflammation
* A3= severe inflammation
A 5-point scale is used in grading the degree of liver fibrosis:
* F0= no fibrosis
* F1= Periportal fibrosis expansion
* F2= Portal-portal septae (>1 septum)
* F3= Portal-central septae
* F4= cirrhosis "
"Cirrhosis is defined histologically as a diffuse (throughout) hepatic process characterized by fibrosis and the conversion of normal liver architecture into structurally abnormal nodules."
Scarring occurs only during cirrhosis Stage 4. The scar tissue changes the structure of the liver into one of either small or large nodules. Only scarring creates portal hypertension which creates the complications such as varices, enlarged spleen, etc. When the term F3-F4 is used it means that only some of the liver architecture has become nodular.
There is no scarring without cirrhosis. Cirrhosis by definition is scaring of the liver.
As Eureka correctly states there are 3 separate "stages" of cirrhosis as measured by the Child-Pugh-Turcotte (CPT) classification system. Or the degree of advanced liver disease is more commonly measured using the MELD system of points from 6-40 is used.This is the scale used to determine who gets transplanted.
Hector
The Metavir grading system uses two standardized numbers: one to indicate degree of inflammation (tissue swelling and irritation) and the other the degree of fibrosis (tissue scarring due to prolonged inflammation).
A 4-point scale is used in grading the degree of liver inflammation or histological activity:
* A0= no inflammation
* A1= mild inflammation
* A2= moderate inflammation
* A3= severe inflammation
A 5-point scale is used in grading the degree of liver fibrosis:
* F0= no fibrosis
* F1= Periportal fibrosis expansion
* F2= Portal-portal septae (>1 septum)
* F3= Portal-central septae
* F4= cirrhosis "
"Cirrhosis is defined histologically as a diffuse (throughout) hepatic process characterized by fibrosis and the conversion of normal liver architecture into structurally abnormal nodules."
Scarring occurs only during cirrhosis Stage 4. The scar tissue changes the structure of the liver into one of either small or large nodules. Only scarring creates portal hypertension which creates the complications such as varices, enlarged spleen, etc. When the term F3-F4 is used it means that only some of the liver architecture has become nodular.
There is no scarring without cirrhosis. Cirrhosis by definition is scaring of the liver.
As Eureka correctly states there are 3 separate "stages" of cirrhosis as measured by the Child-Pugh-Turcotte (CPT) classification system. Or the degree of advanced liver disease is more commonly measured using the MELD system of points from 6-40 is used.This is the scale used to determine who gets transplanted.
Hector
Stage 1 of liver disease is actually what is considered a little scarring.
Stage 4 liver disease is what is known as cirrhosis, when the majority of the liver is scarred. There are other symptoms that occur as Stage 4 gets worse, and an enlarged spleen and bleeding varices are a few of the problems that can occur in someone with Stage 4 and chronic hcv. When the liver has sustained scarring to Stage 4, it is best to be managed by an experienced hepatologist, especially good if one at a Transplant Center is available.
Stage 4, synonymous with cirrhosis, is further classified by extent of scarring, from bad, to pretty bad, to really bad, and that progression is referred to as Class A, B, or C cirrhosis, C being End-Stage Liver Disease. Cirrhosis is often the result of chronic hcv, and successful treatment can halt cirrhosis and possibly even reverse damage for some sufferers. Endoscopy to check for varices is usually undertaken when there is suspected/known cirrhosis; it is also advised that people with cirrhosis have ultrasound minimally every six months to screen for malignancy.
Stage 4 liver disease is what is known as cirrhosis, when the majority of the liver is scarred. There are other symptoms that occur as Stage 4 gets worse, and an enlarged spleen and bleeding varices are a few of the problems that can occur in someone with Stage 4 and chronic hcv. When the liver has sustained scarring to Stage 4, it is best to be managed by an experienced hepatologist, especially good if one at a Transplant Center is available.
Stage 4, synonymous with cirrhosis, is further classified by extent of scarring, from bad, to pretty bad, to really bad, and that progression is referred to as Class A, B, or C cirrhosis, C being End-Stage Liver Disease. Cirrhosis is often the result of chronic hcv, and successful treatment can halt cirrhosis and possibly even reverse damage for some sufferers. Endoscopy to check for varices is usually undertaken when there is suspected/known cirrhosis; it is also advised that people with cirrhosis have ultrasound minimally every six months to screen for malignancy.
Stage 4 cirrhosis is the start of cirrhosis hcv needs to be treated that will slow or even stop the cirrhosis. And continued treatment will manage it.
I was recommended to see a hepatologist but they were so far up the road that I choose to see a GI doc. You are right the GI doc acts a little like he dont no quit what to do so i think i will go first to a hepatologist even if he is a long drive up the road i want to live till iam at lest 80. I read that people with cirrhosis some live with proper treatment to be 90.
Sorry but I wanted you to know that there are four stages of scaring and four stages of cirrhosis, my best friend has had stage 4 cirrhosis for about three years now and she is still alive and well. I know that she does not have long but she hasn't given up either. So hang in there, there is hope.
I just had my biospy and my doctor said that I had scaring and my stage was not cirrhosis he said that mine was in stage three going toward four, so I needed to begin the treatment. So I am starting tomorrow. Sept. 2. You don't necessarily have cirrhosis if you have scaring.
Welcome and thanks for posting. The info you posted is somewhat helpful but specifics such as actual numbers and quotes from test are really more helpful. This is so we can provide info that is based upon the true status of your condition. I should be stated as Grade and Stage. There will also be text describing any other abnormalities that are found. Since you say that scarring was found and you have an enlarged spleen and varices it seems pretty clear that you have Stage 4, cirrhosis of the liver.
The endoscopy is performed to see how extensive your varices are. This is used to decided if you will need treatment to prevent them from bleeding. This has nothing to do with treatment medicine. It is part of your evaluation of how severe your liver disease is currently. And will be compared to over time.
Yes these are all normal procedures that should be done to assess the degree of liver disease.
Since you have cirrhosis you should be referred to a hepatologist who is an expert on liver disease. Cirrhosis of the liver can in time be a fatal illness and needs a very knowledgeable and experience liver expert to help you manage it. Your doctor is doing the right things but he/she is not an expert on liver disease. If something is missed or not understood it could have have a major impact on the life. This is not something to be taken lightly. You can work with both doctors.Your GI for routine matters and the hepatologist on matters only they can assist you with. This is especially important as your disease progresses and you start to have symptoms and complications.
Take care. Hang in there.
Hector
The endoscopy is performed to see how extensive your varices are. This is used to decided if you will need treatment to prevent them from bleeding. This has nothing to do with treatment medicine. It is part of your evaluation of how severe your liver disease is currently. And will be compared to over time.
Yes these are all normal procedures that should be done to assess the degree of liver disease.
Since you have cirrhosis you should be referred to a hepatologist who is an expert on liver disease. Cirrhosis of the liver can in time be a fatal illness and needs a very knowledgeable and experience liver expert to help you manage it. Your doctor is doing the right things but he/she is not an expert on liver disease. If something is missed or not understood it could have have a major impact on the life. This is not something to be taken lightly. You can work with both doctors.Your GI for routine matters and the hepatologist on matters only they can assist you with. This is especially important as your disease progresses and you start to have symptoms and complications.
Take care. Hang in there.
Hector
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