How is liver cirrhosis diagnosed?

Diseases of the liver may not show symptoms in the early stages, and can therefore remain undetected for a long time.1 Your doctor may suspect cirrhosis if you have certain symptoms.² They may perform various tests and examinations to confirm the diagnosis, and then decide the appropriate therapy for you.¹

What tests are done to diagnose cirrhosis?

If a liver disease such as cirrhosis is suspected, the doctor (usually a hepatologist or gastroenterologist) will use the following assessments:¹

• Blood tests: They will perform a number of blood tests, particularly “liver function tests”. An unhealthy liver has a reduced capacity to filter harmful toxins and metabolic breakdown products from the blood. Hence, increased levels of these specific breakdown products may appear in the blood. For example, when high levels of bilirubin are present in the blood, this will cause jaundice. Other blood tests may provide the doctor with additional information to help identify the cause of the liver problem.¹
• Physical examination: With cirrhosis, the liver may feel enlarged, and there may be fluid in your abdomen.^4,2
• Imaging: Your doctor may request imaging tests such as ultrasound examination (sonography), magnetic resonance imaging (MRI) or computed tomography (CT). These can show evidence of liver damage and can be used to determine whether the liver is healthy or not.^1,2
• Liver biopsy: If there are changes in the appearance of your liver, your doctor may advise that a small piece of tissue be sampled from it. This will be looked at under a microscope to clarify how advanced the liver disease is, and in some cases whether or not liver cancer has developed.^1,2

In addition to the examinations and tests outlined above, the doctor will also ask you in detail about your medical history and lifestyle. Your alcohol consumption, your family history, and medications are all of particular interest. Other diseases, such as hepatitis infection, may cause or contribute to your liver disease, so your doctor may explore your risk of having these infections. This may include asking you questions about your sexual history, blood transfusion history or tattoos.¹

It is important that you answer these questions honestly. They provide important information necessary for diagnosis and appropriate treatment. If you feel uncomfortable, remember: There is hardly anything that a doctor hasn’t already seen or heard. Be open with your doctor – it’s in your best interests.¹

The stages of cirrhosis

Cirrhosis is a progressive disease. In order to accurately assess how advanced the disease is, doctors divide it into different stages.³

The Child-Pugh score is the points system designed for this. Blood test results or clinical signs, such as the presence of ascites, receive a certain number of points. If the doctor adds up these points, they can stage the disease and plan the treatment accordingly. The scale ranges from “Child A” (mild disease) to “Child C” (severe disease).³