Liver Disease & Hepatology
Liver problems range from an isolated abnormal blood test to advanced chronic liver disease. Care begins by establishing the cause, assessing the degree of liver injury and deciding what treatment or monitoring is needed.
Reasons patients are referred
Common reasons include abnormal liver enzymes, fatty liver, jaundice, viral hepatitis, autoimmune liver disease, alcohol-related liver injury, medication-related liver injury, cirrhosis, fluid retention or complications of portal hypertension.
How liver disease is assessed
Depending on the presentation, assessment may include blood tests, ultrasound or other imaging, non-invasive fibrosis assessment and occasionally liver biopsy. The aim is to identify the cause and determine whether there is significant fibrosis or cirrhosis.
Fatty liver disease
Fat accumulation in the liver is common and may be associated with metabolic risk factors. The important question is whether inflammation or fibrosis is present. Management is individualised and often includes attention to weight, metabolic health and cardiovascular risk alongside liver monitoring.
Cirrhosis and portal hypertension
Patients with advanced liver disease may need surveillance and prevention strategies for complications such as varices, ascites, encephalopathy and liver cancer. New jaundice, vomiting of blood, black stools, confusion or rapidly increasing abdominal swelling requires urgent assessment.
Complex liver disease
Where appropriate, care may involve coordination with radiology, surgery, oncology or specialist liver and transplant services.
The approach
Liver results can be difficult to interpret without context. The aim is to explain what the abnormality means, which investigations are genuinely necessary and what can be done to protect liver health over time.
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