In collaboration with Liver4Life
Knowing the difference between cirrhosis and fibrosis is important. It will give you a clear understanding of where you are in the journey of managing your liver health. Both conditions are as a result of damage to the liver. My Liver Exam helps you to understand these two stages.
First, a short video to understand the main issues regarding liver fibrosis :
Liver damage follows a clear path, illustrated below:
Early fibrosis offers a warning sign that something needs to be addressed to improve the health of your liver. Whereas a diagnosis of significant fibrosis or cirrhosis can mean that urgent attention and medical action is required.
What is fibrosis?
Fibrosis is the term used to describe mild scarring in the liver. Fibrosis occurs when the liver is repeatedly or continuously damaged or inflammed1. It is a condition that can be reversed if spotted in the early stages and steps are taken to prevent further damage.
Identifying and dealing with the cause can usually achieve reversal of early fibrosis.
If damage is repeated or continuous (as occurs in chronic hepatitis), liver cells will attempt to repair themselves, but the attempts may result in scar tissue1. This continuous cycle, over a period of months and years, may cause more significant, advanced fibrosis and proceed to cirrhosis.
Why can fibrosis have a negative impact on your liver?
Scar tissue replaces liver cells, however it has no useful function. Scar tissue can interfere and prevent blood flow to and within the liver, limiting the blood supply for the liver cells2.
This lack of blood flow can cause liver cells to die, causing a knock-on effect where more scar tissue is formed2. Also, due to the lack of available places for the blood to go, it causes increased pressure in the vein that carries blood from the intestine to the liver (portal vein) — this condition is called portal hypertension (this usually occurs in the cirrhosis phase2).
It is worth noting that fibrosis can develop more rapidly when it is caused by a blockage in the bile ducts – this is the case with conditions such as Primary biliary cholangitis/cirrhosis (PBC) and Primary sclerosing cholangitis (PSC). Also worth noting is that a single episode of injury or damage, even if severe, does not usually cause fibrosis2. The damage has to be sustained over a period of time for it to have an impact on liver health.
Fibrosis can sometimes be reversed if the cause is identified promptly and corrected2. However, after months, or years, of repeated or continual damage, fibrosis can develop. The scar tissue can be found throughout the mass of the liver, destroying the liver’s internal structure and affecting the liver’s ability to regenerate itself and function. Such severe scarring is called cirrhosis2.
What can be the diagnosis for cirrhosis?
Cirrhosis has traditionally been thought of as a permanent condition where the damage done is irreversible. Although a serious condition, recent research indicates that cirrhosis can be reversed in cases where the underlying cause can be successfully treated3 to some extent. Novel therapeutic strategies are under investigation to target specific steps in the process of ‘fibrogenesis’ with the aim of reversing advanced fibrosis/cirrhosis.4
As previously mentioned, portal hypertension can be one of the earliest and most important consequences of cirrhosis. Indeed, if cirrhosis is left untreated, portal hypertension can in some case cause severe problems.
What can be the causes of cirrhosis?
Various liver conditions can continuously damage the liver and may cause fibrosis. The most common causes in the UK include alcohol, viral hepatitis and weight-related conditions, such as non-alcohol related fatty liver disease (NAFLD). Other conditions include5:
- Liver related hereditary metabolic disorders (such as haemochromatosis and Wilson’s Disease)5
- Autoimmune disorders (such as PBC, PSC and autoimmune hepatitis)5
- Disorders that affect blood flow to, in, and out of the liver (such as Budd-Chiari syndrome, Heart failure, Portal vein thrombosis)5
- Veno-occlusive disease of the liver (blockage of the small veins in the liver)5
What can be the complications linked to cirrhosis?
This is because the liver is able to function properly despite being damaged. Noticeable problems tend to develop as the liver becomes more damaged. As the condition progresses, symptoms tend to develop when liver functions are affected6, including:
- tiredness and weakness6
- loss of appetite6
- weight loss and muscle wasting6
- feeling sick (nausea) and vomiting6
- tenderness or pain around the liver area6
- tiny red lines (blood capillaries) on the skin above waist level6
- very itchy skin6
- yellowing of the skin and the whites of the eyes (jaundice)
- a tendency to bleed and bruise more easily, such as frequent nosebleeds or bleeding gums6
- hair loss6
- fever and shivering attacks6
- swelling in the legs, ankles and feet caused by a build-up of fluid (oedema)6
- swelling in your tummy (abdomen) caused by a build-up of fluid known as ascites – severe cases can make you look heavily pregnant6
To have a better understanding of cirrhosis complications, feel free to watch this video :
Conclusion
Physicians can often diagnose fibrosis and cirrhosis, estimating its severity based on results of blood and imaging tests, but sometimes a liver biopsy is preferred. Specialist non-invasive tests that measure the stiffness of the liver are being increasingly used by the medical community and are becoming more readily available to patients across the UK. These tests can give a very good indication of the state of the liver and whether fibrosis or cirrhosis is present.
Liver icons ©EstherQueen999
References:
- Ismani; Saudi J Gastroenterol. 2009 Jan; 15(1): 72–79.doi: 10.4103/1319-3767.45072. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2702953/ [Accessed: 28 March 2017]
- Civan J.M., MSD Manual. Consumer version. Fibrosis of the Liver. http://www.msdmanuals.com/en-gb/home/liver-and-gallbladder-disorders/fibrosis-and-cirrhosis-of-the-liver/fibrosis-of-the-liver [Accessed 25 April, 2017]
- NHS Choices. Treating cirrhosis. http://www.nhs.uk/Conditions/Cirrhosis/Pages/Treatment.aspx [Accessed 28 March 2017]
- A. A. Sohrabpour; M. Mohamadnejad; R. Malekzadeh. Review Article: The Reversibility of Cirrhosis. Aliment Pharmacol Ther. 2012;36(9):824-832. http://www.medscape.com/viewarticle/772507_1 [Accessed: 28 March 2017]
- Civan J.M., MSD Manual. Consumer version. Fibrosis of the Liver. Table containing Some Conditions and Drugs That Can Cause Fibrosis of the Liver. http://www.msdmanuals.com/en-gb/home/liver-and-gallbladder-disorders/fibrosis-and-cirrhosis-of-the-liver/fibrosis-of-the-liver#v11555896 [Accessed 28 March 2017]
- NHS Choices. Cirrhosis – Symptoms. http://www.nhs.uk/Conditions/Cirrhosis/Pages/Symptoms.aspx [Accessed: 28 March 2017]
My age is 67 and I have been taking lamivudin 100mg for more than 15 years and my current ALT reading is within the normal range. However, my HBV viral load is 95 iu/mL.
My fibroscan result is 10.2 kPa which equates to Fibrosis Stage 3. My doctor has now recommended that I switch to tenofovir 300mg. Please advise if I should do so because I fear the side effects and the high costs.
Dear Jacky,
The goal of our website is to raise awareness about the importance of the liver. However, we cannot replace your doctor regarding health advice. He/she is the right person to talk to if you are afraid of tenofovir’s side effects.
Let us know if you need more information. We wish you good luck for the upcoming weeks in your health course. And talk to your doctor about your worries.
Best regards.
My Liver Exam team
I have PBC and stage 3 fibrosis..
Hello Eve Jones,
Do you have a question for us?
Many thanks.
I have just being diagnosed with Per Cellular Liver Fibrosis stage 3 after a liver biopsy. Dr wants me to continue taking crestor for hyperlipidemia, Diovan for hypertension and B12 shots for anemia. I have the hemochromatosis gene but not the disease. I am being told that the meds with diet and exercise, and monitoring my blood work quarterly is all that can be done at this time manage the fibrosis so doesn’t turn into Cirrhosis. Has anyone ever been through anything similar?
Dear Vance,
Unfortunately, were are not doctors, we cannot state diagnostic. But if you tell us which country you come from, maybe we can contact a patients association from your country.
Then, you will probably meet patients in the same condition as you.
Thanks for your answer,
Best regards.
My Liver Exam team
I want to know that what is the last stage of liver cirrhosis and a person how much time can lead his life with this disease and if the report says there is severe cirrhosis of 14.29kpa then what effects upon the human body. My mobile phone no. Is 09915432447.I am Indian and belong to middle class family. Please help me.
Dear Narinder, thank you for contacting us.
Unfortunately, we are not doctors. Each liver situation depends on individuals. But we strongly recommend you to go to Chennal Liver website. This patients association is really helpful, and you can follow them on social networks, and ask them your questions. Their website : http://www.chennailiverfoundation.org/
Their contact information below :
Landline: +91-44-26414200
Mobile: +91-95001 76660
Email: info@chennailiverfoundation.org
While waiting for their answer, you can still get some information about how to live with liver disease here : http://www.myliverexam.com/en/what-to-do-when-you-have-liver-disease/
We wish you very good luck for the upcoming months, hoping that 2018 will bring you good fortune.
Do not hesitate if you have any more question,
Best regards.
My Liver Exam team
My husband is partha Debnath, his liver stiffness is 18 pa..it is cureable?
pls are there any habal remedy for cirohssic
Dear Abiodun, thank you for contacting us,
Unfortunately, we are not legitimate to prescribe any medication. We are not doctors.
What we can give you as an advice is to get closer from your GP. He/she will be the only legitimate person to prescribe the right medication to you, depending on your condition.
We wish you good luck for the next steps,
Best regards.
My Liver Exam team
It’s a pity you don’t have a donate button! I’d most certainly donate to this outstanding
blog! I suppose for now i’ll settle for bookmarking and adding your RSS feed to my Google account.
I look forward to new updates and will share this blog with my Facebook group.
Chat soon!
Hello Violet Moritz, and thank you for contacting us.
Unfortunately, we are only an information blog, so no donation required.
But do not hesitate to share our content to spread awareness about liver health on social networks.
And all the best for 2018.
Best regards.
My Liver Exam team
my husband has had a fatty liver for over 20 years…. had teats done consistently….now he has stage 3 fibrosis! Anyone have this condition??
Hello Suzy, and thank you for your email.
To find some advice, or maybe talk to people facing the same condition than your husband, we recommend you to check our list of patients associations http://www.myliverexam.com/en/directory/.
You might find one in your country, and then contact them to explain your husband’s condition.
Do not hesitate to ask anymore question on our website. We hope this answer helps you.
Best regards,
My Liver Exam team
I have had my fatty liver for maybe 15 years.im at stage 3 fibrosis
I’ve just been told I have scarring on my liver and they’ve found lymph nodes on my pancreas, I’ve had chronic Crohns Disease since I was 32, I’m 52 now. I lost most of my small intestine approx 10 years ago due to a gangrenous bowel, I had a stoma reversal due to short gut syndrome. My liver function came back with high levels. Bili 3, ALP 157, GGT 41, the last two markers are within range. Can anyone please share any helpful information, at the moment I’m just constantly waiting on tests and no ones giving me any feedback, except seeing my GP going white as a ghost and frantically trying to get me in to see my Gastro earlier.
Regards Tona
Dear Tona, thank you for your comment,
You must not stay alone while facing your condition. You must talk to appropriate persons who will advise you on how to manage your disease.
If you tell us your country, we can send you some contacts of local patients associations, that might be very helpful for you.
Best regards,
My Liver Exam Team.
How early in fibrosis is it believed that the disease has not progressed far enough so that it becomes at least feasible that reversibility or long-term disease stabilization is possible?
Hello Jim, and thank you for your comment,
Unfortunately, we are not able to evaluate someone’s fibrosis stage : it varies from one patient to another. Your GP is the only person who will be able to appreciate your liver condition, and advise you to contact a hepatologist.
Many ways to evaluate your liver exist, some tests are invasive, some are not : http://www.myliverexam.com/en/what-are-the-different-tests-to-evaluate-your-liver/
So we recommend you to contact your doctor or a patients association. If you tell us your country, we can give you some of these contacts.
Best regards,
My Liver Exam Team.
I have just been diagnosed with NASH and early Stage 4 of cirrhosis. My Doctor didn’t put me on any medication and told me to take 2 vitamin E twice a day to slow the process down. Is this normal not to be on some type of medication
Dear Loretta, thank you for your comment.
We understand your condition, but we do not have the legitimacy to judge your doctor’s diagnosis.
But what we can do, is advise you to contact a local patients association in your country.
We just need you to tell us in what country you live in.
You must not stay alone while facing your condition. You must talk to appropriate persons who will advise you on how to manage your disease.
Best regards,
My Liver Exam Team.
my liver fibroscan size is 16.5. whether it is reversible? and what is suggest treatment on it please tell me
Dear Deepak, thank you for your comment.
Unfortunately, we cannot give you a diagnostic : we cannot replace your doctor and we do not really know your condition. But, as a patient, you deserve answers from your GP. Contact him/her and ask about treatment. You can also contact a patients association in your country : http://www.myliverexam.com/en/directory/
Feel free to ask more details about these associations.
Best regards,
My Liver Exam team.
my liver fibroscan size is 16.5. whether it is reversible? and what is suggest treatment on it please tell me?
vrey useful.
very useful information.thanks.
My husband was diagnosed with chirosis a year ago. The last few months, he bleeds for a couple of days at a time. The last few days, his personality has been changing. I have no idea about his prognosis. What stage is he in? How long might he have?
Dear Gloria,
We are not legitimate to give a diagnostic for your husband’s condition. You must get closer to your doctor. He/she is the only legitimate person to guide you for the next steps. Remember that, as a patient, your husband has the right to know his stage of cirrhosis. The first information to get would be : is it a compensated or decompensated cirrhosis?
Here is how we can help you :
– you can read more in this article about different tests to evaluate the liver. Some are painless and non invasive : http://www.myliverexam.com/en/what-are-the-different-tests-to-evaluate-your-liver/
– you can contact a patients association in your country. You can find our list at the bottom of this page : http://www.myliverexam.com/en/action/living-with-the-disease/
Do not hesitate if you have further questions.
Sincerely yours,
My Liver Exam team.
hi everyone i m from azad kashmir pakistan .my son is 5year old and saffring from liver fibrosis what should i do .is he recover .is fibrosis heal? kindly help me .
Dear Mona,
As you can read in this article, ‘Fibrosis can sometimes be reversed if the cause is identified promptly and corrected’. But the only person who can give you a proper answer is your doctor. Indeed, this is the only person who really knows your son’s liver condition. As a patient, you deserve proper answer about how your son got affected, and how to reverse fibrosis.
Do you know any patients association in Pakistan? They can be appropriate spokespersons.
Do not hesitate to get back to us for more questions.
Sincerely yours,
My Liver Exam team.
Hi I am 37 y/o . I recently had a fibroscan of 40.6 I have been alcohol free for 11 months now. I have never been told what stage of cirrhosis I have with that score anyone know what stage that would be? I have already gone through the severe jaundice, ascities, edema. All have improved. I feel way better just always tired. Any thoughts ?? Also gained facial blemishes and lost so much hair. Doctor just we dont know yet it takes time to know. Any thoughts would be appreciated☺?
Dear Cynthia,
You may not have cirrhosis stage. The only person who can interpret your FibroScan results is your doctor.So you must get closer to him/her, to collect more information. This is your right as a patient. You can also contact a patients association for more advice. Here is our list : http://www.myliverexam.com/en/action/living-with-the-disease/
Do not hesitate if you have other questions.
Yours faithfully,
My Liver Exam Team.
What is treatment in liver fibrosis
Stage f4
Hello Hardeep,
The only person who can give you a legitimate interpretation for your fibrosis stage is your doctor. As a patient, you have the right to know the next steps to manage your fibrosis.
You can also contact a patients association for more advice. Here is our list : http://www.myliverexam.com/en/action/living-with-the-disease/
Do not hesitate if you have other questions.
Yours faithfully,
My Liver Exam Team.
I have stage 4 liver disease, and am i the compensated stage of stage 4. I had a fatty liver, as a child, and am genetically prone to liver cancer. My hepitatis C was diagnoised in 2010, and I had lived with it 10 years. I have been diagnoised with cirrhosis of the liver since 2011, and have stayed in compensated stage . How long do I have to live.
Dear Bethanie, thank you for your comment,
We are deeply sorry to hear about your condition.
You need to get closer to your doctor : as a patient, you have the right to know if your condition may evolve or not.
Do not panic or desperate : you first need to have your liver cheked, and get medical advice. Liver conditions vary from one individual to another.
Your doctor is the only person who has the legitimacy to tell you what to do.
You can also ask your questions to patients associations. A famous one is the American Liver Foundation : depending on where you are located in the United States, you can contact them here : https://liverfoundation.org/for-patients/contact-us/
We hope this answer is useful to you, and do not hesitate to contact us again. We are here to do our possible to help patients.
Yours faithfully,
My Liver Exam Team.
Hi there. I had my gallbladder out along with a liver biopsy. Iv been told i have mild fibrosis with minimal inflammation. Do you know what steps are took next please and how quick does it take to turn in to a more serious psc or along those lines please. Its been coming up 6wks now since i had my op but says on my letter they wanted to see me within 2/3wks. Iv had app cone through as a follow up from the gallbladder dr in October but nothing from the liver specialist. Anyone have any ideas or reassurance ild be very grateful. Thanks in advance
Dear Kerry, thank you for your comment.
What is certain, is that, if you are supposed to have a medical visit after your operation, it is not an option.
Regarding your level of fibrosis, it varies from one individual to another, including several factors, such as diet, standard of living, etc..
The only person who has the legitimity to advise you is your GP. He or she may then recommend you to see a hepatologist.
As a patient, it is your right to get more information about your situation.
We hope we answered your question. Do not hesitate to contact us again for further information.
Best regards,
My Liver Exam Team.
Got results from fibroscan came back as stages f4 got appointment for liver clinic on 2nd October don’t know what to expect.
Dear Dawn, thank you for your comment.
The only legitimate person is your GP or hepatologist.
He or she is the only person able to explain your results to you.
We hope you’ll get your answers by the 2nd of October.
As a patient, it is your right to ask for details, and for the next steps.
Yours faithfully,
My Liver Exam Team
Thank you for your response hospital consultant says i have cirrhosis but i feel okay hardly any symptoms i still think have they made a mistake not given me any medication I’ve more blood tests and need another liver scan.
Dear Dawn, thank you for your comment.
Please understand that we don’t know you condition, so we don’t have the legitimacy to tell you what to do.
If you need other liver exams, you can read our dedicated article here : http://www.myliverexam.com/en/what-are-the-different-tests-to-evaluate-your-liver/
But your doctor is the only person able to tell you what your condition really is.
We hope this answer brings you enough information.
Do not hesitate to contact us again.
Best regards,
My Liver Exam Team.
Thank you for your response i let you know more off my condition i know you can’t help thanks for your help.
I have gone to delhis best gastroentrolosit.Such as Blk hospital Saroj Hospital some pvt drs.Then shown in ILBS VASANT Kunj.but no dr has advised me the correct treatment n suffring frm all the systems to liver problem.Scans xrays blood tests endoscopy has already been done .Suferrin since March 2017.Also i had stunt in my main artry in sep.2018.
After going so many drs in they r given their own recomemded medices line of treatment.if u say i can send my reports.thanx.
Dear Miss Gilani, thank you for your message.
Unfortunately, we do not have the legitimacy to interpret your results.
The only persons who can do it are the ones that did your exams (screenings and blood tests).
As a patient, it is your right to obtain all the information you need about your liver state.
This awareness is crucial, in order to start the next steps in necessary (for example, further tests, specific diet…).
But do not hesitate to contact us again if you have anymore questions.
Yours faithfully,
My Liver Exam Team.
Today I did My fibro scan results 47.2k,
Anmonth before dr diagnosed as cirosis and were given diet restrictionsr and medicine for cirosis. Kindly tell me the way forward and seriouness of my situation by email
br
Hello Praveen, thank you for your email.
You must follow your doctor’s diet restrictions. Your doctor is the only person who is legitimate to tell you what to eat or not.
We can only give you some advise, with this article : http://www.myliverexam.com/en/diet-and-liver-diseases/
Do not hesitate to contact us again for more information.
Best regards,
My Liver Exam Team.
My age is 32.I’m suffering from moderate fatty liver disease and my fibroscan result is 7.12kpa. My doctor has given me viboliv-500 for fatty liver but he has not given any medicine for fibrosis. I’m very much afraid of the disease. Kindly tell me ,is there any chance that my fibrosis getting worse without any reson? I’m having boiled food since i have been diagnosed. Is there any chance of getting worse? Kindly tell me… will i be okay?
Hello Bairagi Charan, thank you for your comment.
It may vary from one individual to another, depending on several conditions we are not legitimate to talk about.
But usually, fibrosis gets worse when the liver is repeatedly or continuously damaged or inflammed.
Therefore, aggravation risks decreased if the reason of repeated inflammation is reduced, or limited.
Follow-up with your doctor is very important, and you must follow his/her instructions regarding food habits.
Remember that your doctor is the only legitimate person to make a statement about your liver, and see if fibrosis have increased or dicreased.
Do not hesitate to contact us for more information.
We sincerely hope that your condition may improve.
Best regards,
My Liver Exam Team
Is f3 fibrosis serious?
Dear Diana,
We asked Liver4Life (who wrote the article) to provide you an answer :
Fibrosis stage 3 can be deemed serious if there is a high chance you will progress to stage 4 and then cirrhosis, which may cause permanent damage to the liver.
Stage 3 should be taken very much as a warning signal that the liver is inflamed, however you have time and a chance to reduce disease progression by drug therapy or by undertaking lifestyle changes, depending on the type of liver condition you have.
Do not hesitate if you have more questions.
Best regards,
My Liver Exam Team
I have cirrhosis I got it from hep c and alcohol I need to know the stages
Is f2 fibrosis serious?
My SGPT 61 IU/L & SGOT 42 IU/L, My age is 41 yrs
Fibro scan result 17.8 kpa . Sgot 88,sgpt 93,alubin 4.4gloubin 3.8,billiburion 1.1 blood report.I am ALD patient.ultra sound conclusion mild heptamology. Humko cirrhosis hai agar haan ye thik ho sakta hai
I just learn of my father fatty liver disease.
He had surgery where the surgeon froze part of the liver to stop the cancer from spreading. I can’t see him because of Coronavirus. I feel a little good I found this thread and know I’m not alone. Blessings to everyone.
Hi Guys,
I recently had a Fibroscan done on my liver which apparently came back O.K
However an ultrasound showed I had fatty liver and also another small spot or area that they need to do a CT on as they could not get a clear look at
What I wanted to know is – if the fibroscan was O.K – what would be the chances that the spot on my liver would be something bad or suspicious?
I feel quite well in myself but of course you worry about these things and until I have the CT in a few days I am not going to know any more so I just though I would ask the question.
Many Thanks!
Natalie
Hi last year I was admitted to hospital with alcohol hepatitis 15 months later my bloods are all showing as good I missed scan last month but I want to know if I can make full recovery.
On Elastography report on 19.3.2020 it is found that I have liver fibrosis grade 3 and Liver function test on 16.5.2020 my sgpt is 34.1 and sgot is 41.3 and as per doctor Prescription I an using the following medictions since 19.3.2020.
1) Razo 20 one tab. Twice daily
2) librax One tablets thrice daily
3) Ursetor( ursodeoxycholic acid) 300mg One table twice daily.
Doctor adviced me to meet him on 3.6.2020.
My question is with mediation how long I can live without any transplation
With regards
Shyama prasad Mondal
9002996462
I have hcv positive. My Alt and Ast is normal .my viral load is 821705 then I cure after the treatment . This show l have no liver damage. Please about me
Hello
Your knowledge is very helpful for me
Thank you so much
Good
I am 66 yrs. 5’2″ 185lbs. and have stage 3 fibrosis. I have been told to lose weight. Nothing else. What else can I do to reverse or at least stop the progression. Thank you.
My Kpa was 13.1 what does this mean
I had a liver MRI and the results are that I have stage 3 fibrosis. Can I pay a doctor in your organization for a second opinion? I can sign a release and send the the MRI results. Thank you.