How is it Diagnosed?
Chronic Liver Disease is diagnosed through a combination of clinical evaluation,
laboratory tests, and imaging studies. The diagnosis often starts with a detailed history
of alcohol consumption, viral hepatitis, metabolic conditions, or autoimmune diseases.
Symptoms like fatigue, jaundice, abdominal distension, and pruritus raise suspicion.
Physical examination may reveal hepatomegaly, splenomegaly, ascites, spider
angiomas, or palmar erythema. Initial laboratory tests include liver function tests (LFTs)
which measure ALT, AST, bilirubin, alkaline phosphatase, and albumin levels. A persistent
elevation of transaminases or low albumin and raised bilirubin indicates ongoing hepatic
injury and dysfunction.
Serological tests for hepatitis B and C, autoimmune markers (ANA, SMA, AMA), and
metabolic indicators (ceruloplasmin, iron studies) help identify the etiology. Coagulation
profile (INR/PT) is also crucial, as it reflects hepatic synthetic function.
Imaging with abdominal ultrasound helps assess liver texture, surface nodularity, and
signs of portal hypertension like splenomegaly and ascites. Transient elastography
(FibroScan) and MR elastography provide non-invasive estimation of liver fibrosis.
Liver biopsy remains the gold standard for definitive diagnosis and staging of fibrosis or
cirrhosis, though it's reserved for unclear or complex cases. The MELD score (Model for
End-stage Liver Disease) helps assess prognosis and transplant need.