Can I insist on a liver biopsy?

[Sam200819]

I suspect I have liver disease caused by years of alcohol abuse. My doctor's won't listen to me and say that I have normal blood tests including CBC, LFT's, PT/INR, complete hep panel etc. I was referred to a Gastroenterologist and he says he won't do a biopsy with normal blood tests and imaging (had ultrasound and cat scan). I have symptoms of liver disease which include spider angiomas, red palms that look mottled, ruq pain sometime with nausea etc. Can I insist on a biopsy? I really feel like nobody is taking me serious. Thank you for any input.

[Jonkob5580]

I am in the same boat as you. Normal bloods and just a fatty liver. But I have pale nails, have had pale nails for 20 years. And now I see the spiders.
As long as my bloods are normal I'm just going to live life and try not to obsess over it. If your really sick you will know it sooner or later. Lexapro has also helped me. Trust your doctors and relax

[Sam200819]

Thank you CalGal.

[CalGal]

It would show indications of problems with acid reflux, H. pylori, celiac disease, bile reflux, etc.

Typically, if you had a problem with liver disease, your enzyme levels would be elevated.

Mottling/changes of the hands is found in liver issues, but typically only when the liver enzymes/bilirubin are already showing changes.

[Sam200819]

Thank you for your answers. I have the spider angiomas on my skin no angioma on the liver was found. And everywhere I read and research it says that it is related to liver disease or pregnancy. I had my child 6 years ago so the angiomas must be due to my history of alcohol abuse. I completely stopped drinking 8 month ago and haven't seen any improvement, my symptoms are just getting worse. The first symptom that I experienced was ruq pain with nausea. Then I looked a little more and noticed the "red dots" and mottling of my hands. My doctor keeps telling me that I am fine and that there is no indication that would suggest a biopsy. Also after reviewing the copy of my blood tests I noticed that my ALT is very low. The normal range says 14-54 and mine is 12. He still says it is all within normal limits! I guess I will have to find a new doc that will listen to me. He also said that he would do a EGD (scope) since I am experiencing pain. What would the EGD show?

[little57]

I was just diagnosed with a very small hemangioma on my liver. Boy was I scared, It is a benign tumor and does not turn to cancer. You can have many of them with no problems. Through my research I found out that it is very dangerous to do a biopsy on them. There is no gaurantee that they won't hemmorage. They can be removed safely with surgery but biopsies are dangerous. That is probably why your doctor refuses to to one.

[CalGal]

Sam, you can insist, but you'll have to find a doc who will go along with your request. If your present doc doesn't agree, he can simply decline to treat you and will tell you that you may be better off working with someone else. He doesn't have to do any test that he feels is not in your best interest.