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A new solution to liver disease detection
In the past, a patient suspected of suffering from liver fibrosis or possible cirrhosis used to go through a painful biopsy — a strenuous procedure including a thorough interview, physical examination, blood tests and an ultrasound
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n the past, a patient suspected of suffering from liver fibrosis or possible cirrhosis used to go through a painful biopsy — a strenuous procedure including a thorough interview, physical examination, blood tests and an ultrasound.
Unfortunately, despite the tedious and painful process, there was no guarantee the biopsy would show an accurate result. But now, with a new non-invasive technology from France called FibroScan, doctors are able to evaluate the level of fibrotic tissue without causing any physical pain.
What is liver fibrosis?
Liver fibrosis is the excessive accumulation of extra cellular matrix proteins including collagen, which occurs in most types of chronic liver diseases. If left untreated, it may result in cirrhosis of the liver — that will then lead to other serious complications of the liver like portal hypertension, liver failure and liver cancer.
Cirrhosis is a pre-malignant condition and once it is developed, the risk of liver cancer is greatly increased. Presently, cirrhosis and liver cancer are among the top 10 causes of death around the world, and in many developed nations liver disease is one of the top five causes of death amongst middle-age people.
What are the causes of liver fibrosis?
All types of chronic liver diseases (CLD) can lead to liver fibrosis. For many years, chronic viral hepatitis B (CHB) and alcoholic liver disease (ALD) have been known to be the principal causes of CLD.
Despite the falling rates of alcoholism and ALD in many countries, hazardous drinking amongst young people is resulting in alarming rates of ALD.
Over the past decade two other diseases — chronic hepatitis C (CHC) and non-alcoholic fatty liver disease (NAFLD) have emerged as major contributions to the burden of CLD incidence. The hepatitis C virus (HCV) can be transmitted in blood and blood products via unsafe injection practices and the therapeutic use of infected blood products. It is estimated that the world prevalence of CHC is nearly 200 million people.
And in developed countries where the rate of obesity is increasing rapidly, NAFLD is considered to represent a major cause of significant fibrosis. Although it appears that only a small percentage of patients with NAFLD (maybe 20 percent) develop significant fibrosis, due to the vast prevalence of the at-risk overweight population, NAFLD may give rise to an epidemic of liver fibrosis.
Other causes of liver fibrosis also include cancer growth (primary or secondary liver cancer), immune processes (autoimmune hepatitis), over usage of chemicals (pharmaceuticals, recreational drugs, excessive alcohol and exposure to pollutants), metabolic disorders (lipid, glycogen or metal storage disorders) and other liver infections (parasites and bacteria).
Detection of the underlying liver disease is often delayed because fibrotic liver disease may not present clinically until an advanced or cirrhotic stage. In addition, the biopsy needle needs to pierce exactly to the connective or bad liver tissue for the liver disease biopsy results to be accurate.
With FibroScan, patients can now undergo liver disease biopsy with ease. The patient is required to lie down and place the right hand above the head followed by placing the FibroScan probe (similar to an ultrasound probe) on the skin above the liver area. Vibrating waves are released 10 times in specific areas. After which, the result for the condition of the liver fibrosis will be reported.
The entire process takes only three to five minutes. FibroScan is not only limited to Hepatitis B patients. It can also be used to detect other diseases like fatty liver, excessive iron or copper accumulation, autoimmune liver disease and other liver related diseases.
In addition to its accuracy and convenience, this new technique is also pain-free and examines a larger area of the liver. The FibroScan can examine 100 times the area and penetrate as deep as 6 centimeters with a diameter of 1 centimeter compared to the area covered by the thin needle of the biopsy method.
Doctors recommend that patients check their liver using this technique at least once a year. Who knows — the five minutes scan could save you from contracting a liver disease?
However, FibroScan has limitations. Some inaccurate results may be produced for patients who are obese and for those with narrow spacing between their ribs. This new technique is also not suitable for diagnosing tumors or cancer in the liver.
©FlyFreeForHealth2009
Articles in this column, which will appear every two weeks, are provided by a panel of health professionals from www.flyfreeforhealth.com, a leading multimedia medical tourism platform dedicated to providing travel and lifestyle incentives for those adopting a healthy lifestyle. The hospital includes Samitivej Hospital, an international award hospital in Thailand and a service provider of medical tourism in Southeast Asia. Join FlyFreeForHealth’s online seminar for free by SMSing your email address to +65-98IREACH (+6598473224) to receive the exclusive invite. Email us at info@flyfreeforhealth.com.
