Liver Disease

Home » Liver Disease » Diagnosis

Questions to Ask Your Doctor About Your GI Condition
(Free Handout)

Diagnosis

Diagnosis of liver disease usually begins with a medical history and physical examination. The physician often asks questions about the onset and severity of symptoms. During the physical exam, the physician often presses gently on the patient's abdomen to feel for enlargement of the liver and spleen.

If liver disease is suspected, a blood test called a liver panel (also called a liver function test or liver enzyme test) usually is performed. These tests measure levels of certain proteins and enzymes in the blood to determine how well the liver is functioning.

Liver function tests include checking levels of the following substances in the blood:

• Albumin
• ALT (alanine aminotransferase)
• ALP (alkaline phosphatase)
• AST (aspartate aminotranferase)
• Bilirubin (2 different tests: total bilirubin or direct bilirubin)
• GGT (gamma glutamyltranspeptidase)
• LDH (lactic acid dehydrogenase)
• Platelet count
• PT (prothrombin time) or INR (international normalized ratio)
• Serum protein electrophoresis or total protein

In many cases, specific symptoms help determine exactly which tests are performed. For example, if hepatitis A is suspected, the physician may order tests for bilirubin, ALT, and AST.

Diagnosing hepatitis B and C involves additional blood tests for specific antibodies. Other blood tests for hepatitis B can help determine if the patient is contagious and whether the infection is chronic. Additional tests for Hepatitis C can detect which of 6 known strains of the virus are present. This information can help determine the best options for treatment.

Imaging tests (e.g., ultrasound, CT scan, MRI scan, x-rays) may be performed to determine if, and to what extent, the liver has been damaged.

Liver function is affected by the other components of the biliary tract (i.e., the bile duct [small tube that carries bile from the liver to the small intestine], gallbladder, and pancreas). If the physician suspects that a disease of the biliary tract (e.g., gallstones) is causing a liver problem, an examination called an endoscopic retrograde cholangiopancreatography (ERCP) may be performed.

ERCP, which is performed under local anesthesia and sedation, involves passing a special device that contains a tiny light and camera (called an endoscope) through the throat, esophagus, stomach, and into the first part of the small intestine (duodenum). Once the endoscope reaches the biliary tree and pancreas, a contrast dye is injected into the bile ducts and a series of x-rays is taken. The contrast dye allows the bile ducts, gallbladder, pancreas, and liver to show up more clearly in the x-rays.

In some cases, a liver biopsy also may be performed. Liver biopsy involves surgically removing a small sample of liver tissue for microscopic evaluation.

Depending on the symptoms and initial diagnosis, patients who have liver disease often are referred to a medical specialist (e.g., gastroenterologist, hepatologist). In some cases, the patient also may be referred to an infectious disease specialist who has extensive experience with hepatitis B and C patients.

© 1998-2008 Healthcommunities.com, Inc. All Rights Reserved.

Liver Disease Resources

	Join Our Liver Disease Forum Do you have a question, want to share medical advice, or just need to discuss your situation with someone else having a similar experience? The healthchannels forum is a resource for everyone to share and discuss their health and medical needs with others.	Advertising Disclaimer
	Living with...Share your story Do you have a personal health story that you would like to share with others? As a source of free patient education, our goal is to provide our users with trustworthy information and support from others. That's why we've started our "Living with..." sections.
	Our "Living With..." support pages are a place to share experiences about living with a certain condition, disease, disorder, or illness and for loved ones of those dealing with health-related issues. Many people, especially when newly diagnosed, find comfort in knowing that others are having a similar experience. Help others by sharing your story. View stories already submitted.
	Stay Updated Sign up for our newsletter and receive important updates on the medical conditions that are most important to you.
Advertising Disclaimer To quickly access health information from your website's browser, download Healthcommunities.com's healthchannels toolbar. Advertising Disclaimer