Diagnosis of Cirrhosis
Diagnosis of cirrhosis requires a combination of clinical evaluation, imaging studies, blood tests, and sometimes a liver biopsy. Since cirrhosis can remain silent for years, it is often diagnosed when complications arise or during investigation for unrelated symptoms.
1. Physical Examination and History
Doctors will evaluate risk factors such as alcohol use, viral hepatitis exposure, or family history of liver disease. Physical signs such as jaundice, ascites, and enlarged liver or spleen raise clinical suspicion.
2. Liver Function Tests
Blood tests evaluate liver enzymes (ALT, AST), bilirubin, albumin, and clotting factors. Abnormal results can suggest liver injury or dysfunction but may not indicate the extent of fibrosis.
3. Imaging Tests | Diagnosis of Cirrhosis
- Ultrasound is often the first test used to detect liver texture changes, nodules, and fluid build-up.
- CT scans and MRI provide more detailed imaging and are useful for assessing complications.
- FibroScan (elastography) measures liver stiffness and is a non-invasive alternative to biopsy.
4. Liver Biopsy
A biopsy involves removing a small sample of liver tissue to assess the degree of scarring and confirm the diagnosis. While effective, it’s invasive and usually reserved for unclear cases.
5. Blood Marker Panels
Specialised blood tests (FibroTest, APRI, FIB-4) estimate fibrosis severity. These tests can guide diagnosis when biopsy is not feasible.
6. Endoscopy | Diagnosis of Cirrhosis
If portal hypertension is suspected, endoscopy may be performed to look for oesophageal varices, which can bleed and cause serious complications.
7. Scoring Systems
MELD (Model for End-Stage Liver Disease) and Child-Pugh scores help assess disease severity and predict survival, which are crucial in liver transplant evaluation.
Early and accurate diagnosis of cirrhosis allows for timely treatment, lifestyle changes, and close monitoring to delay or prevent complications.
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