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FibroScan Result show a stiffness of 35kpa


I am a 30 year old Type 2 diabetic who was diagonised with NASH and Gilbert's syndrome some 8 years back. A liver biopsy at that time had confirmed the same. I have been living very cautiously since then with hardly any high-calorie intake. Some 3 years back I also developed a gallstone which has been asymptomatic till now.

A week back I had been to a gastroenterologist to discuss about the gallstone and if surgical opinion needs to be taken given that it is completely asymptomatic as I am travelling abroad in some days. The doc adcised me to get a fibroscan just for the sake of it because I had been diagonised with NASH & fatty liver.

The results of the Fibroscan gave me the shock of my life- the results came up with a 35kpa stiffness. I get my LFT and CBC done regularly and there are no major issues(except for very slightly raised SGPT/SGOT levels- around 10-15 points above normal lvls). I also have no symptoms whatsoever (perfectly reasonable level of energy, good apetite etc).

I was advised an endoscopy which I couldnt pursue because of the lack of time but I am extremely scared now because of this.

Some guidance on this would be highly appreciated.

Many Thanks . .
Best Answer
1475202 tn?1536270977
Hello Saurabh and welcome to MedHelp.

At this point it’s probably in your best interest to have a CT scan or liver biopsy for a more accurate diagnosis. If indeed you are cirrhotic then proceed with the endoscopy. Depending on the severity of your portal hypertension Varices may be present. Depending on the grade medication such as nadolol or propranolol may be prescribed to prevent further complications.

In the meantime continue to maintain a healthy diet, avoiding things that are toxic to your liver such as alcohol or pain relief medications. Since you are having no complications from the gallstone it can’t wait. The health of your liver must take to priority. It is not uncommon for persons with cirrhosis to not experience symptoms in the early stage.

I borrowed this from- http://www.webmd.com/digestive-disorders/tc/nonalcoholic-steatohepatitis-nash-overview

Nonalcoholic steatohepatitis (NASH) is liver inflammation caused by a buildup of fat in the liver. Many people have a buildup of fat in the liver, and for most people it causes no symptoms and no problems. But in some people, the fat causes inflammation of the liver. Because of the inflammation, the liver doesn’t work as well as it should.
NASH can get worse and cause scarring of the liver, which leads to cirrhosis. But the disease doesn't always get worse.
NASH is similar to the kind of liver disease that is caused by long-term, heavy drinking. But NASH occurs in people who don't abuse alcohol.
What causes NASH?
Experts don't know why some people with a buildup of fat in the liver get NASH and some don't. It could be that something in the environment triggers the inflammation in those people. Or maybe it runs in their families.
Things that put people at risk for NASH and for liver damage include:
• Obesity.
• Type 2 diabetes.
• High cholesterol and high triglycerides.
• Metabolic syndrome.
Most people who have NASH are 40 to 50 years old and have one or more of the problems listed above. But NASH can happen in people who have none of these risk factors.
What are the symptoms?
You may have no symptoms in the early stages of NASH. Most people who have NASH feel fine and don't know that they have it.
As NASH progresses and liver damage gets worse, you may start to have symptoms such as:
• Fatigue (feeling tired all the time).
• Weight loss for no clear reason.
• General weakness.
• An ache in the upper right  part of your belly.
It may take many years for NASH to become severe enough to cause symptoms.
How is NASH diagnosed?
No single test can diagnose NASH. Your doctor will ask you about other health problems you’ve had.
To see if fat is building up in your liver and to rule out other diseases, your doctor may do tests such as:
• An abdominal ultrasound.
• A CT scan.
• An MRI scan.
Your doctor may do a liver biopsy to be sure that you have NASH. In a liver biopsy, your doctor takes a sample of tissue from your liver and checks it for signs of NASH.
How is it treated?
There is no treatment for NASH. But you may be able to limit damage to your liver by managing conditions that increase your risk for NASH or make it worse. You can:
• Reduce your total cholesterol level.
• Reach a healthy weight. If you need to lose weight, be sure to do so slowly (no more than 1 to 2 pounds a week).1 Quick weight loss from crash diets, surgery, or medicine increases inflammation and scarring in your liver.
• Control diabetes.
• Stop or cut back on drinking alcohol.
• Exercise regularly.
Also, ask your doctor or pharmacist about all the medicines you are taking. Some may harm your liver.
From- http://www.liverfoundation.org/abouttheliver/info/gilbertsyndrome/

Gilbert Syndrome is a mild genetic disorder in which the liver does not properly process a substance called bilirubin. Bilirubin is made by the break down of red blood cells.
Gilbert Syndrome affects three to seven percent of people in the United States. Gilbert Syndrome is more common in men than women.
What causes Gilbert Syndrome?
Gilbert Syndrome is caused by the body having lower amounts of a liver enzyme that breaks down bilirubin. As a result, extra amounts of bilirubin build up in the blood.
What are the symptoms of Gilbert Syndrome?
People with Gilbert Syndrome usually do not have symptoms. Gilbert Syndrome sometimes causes the liver to make too much bilirubin that the person becomes jaundiced (yellowing of eyes and skin).
Certain things can further increase the level of bilirubin in the bodies of those with Gilbert Syndrome:
• Being ill
• Menstruating
• Fasting or skipping meals
• Exercising too much
What are the complications of Gilbert Syndrome?
Complications of Gilbert Syndrome may include certain medications causing side effects in people who have Gilbert Syndrome. Talk to a doctor before taking any new medications.
How is Gilbert Syndrome diagnosed?
Doctors usually diagnose Gilbert Syndrome after reviewing blood test results and ruling out other liver diseases. In people with Gilbert Syndrome, liver function levels will usually be in normal ranges except for the bilirubin level. However, the level of bilirubin in the blood may change frequently and a doctor may repeat the blood tests a few times.
How is Gilbert Syndrome treated?
Since Gilbert Syndrome is a mild and manageable condition, it does not need treatment.
I hope this information will help you out, try not to be too upset without further testing. I wish you the best!

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Avatar universal
Many Thanks for the detailed response.

My family is dead against biopsy- the last time I went for a biopsy 8 years back the doc ruptured a blood vessel and I almost lost my life.

My real fear is docs within India are extremely conservative and as far as I have seen they are almost always a couple of years backdated in terms of the meds they prescribe. And with all the other complications I already have,the correlation between all these situations are not always taken into consideration.
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