Diagnosing Alcoholic Hepatitis: What Tests Do Doctors Use?
Diagnosing Alcoholic Hepatitis: What Tests Do Doctors Use?
The Diagnostic Journey
Diagnosing alcoholic hepatitis can be challenging, but it's crucial for proper treatment. Doctors use a combination of methods to confirm the condition and assess its severity.
Contents
- Blood Tests: The First Step
- Imaging Tests: Looking Inside
- Liver Biopsy: The Gold Standard
- Severity Scoring Systems
Blood Tests: The First Step
Blood tests are usually the first diagnostic tool. Doctors look for elevated liver enzymes, particularly AST and ALT, with AST typically higher than ALT. They also check bilirubin levels, which can indicate how well the liver is functioning. Other important markers include the prothrombin time, which measures blood clotting ability, and serum albumin levels.
Imaging Tests: Looking Inside
Imaging tests like ultrasound, CT scans, or MRI can help doctors visualize the liver. These tests can show if the liver is enlarged or has a fatty appearance, both common in alcoholic hepatitis. They can also help rule out other causes of liver problems, such as tumors or gallstones.
Liver Biopsy: The Gold Standard
While not always necessary, a liver biopsy is the most definitive way to diagnose alcoholic hepatitis. In this procedure, a small sample of liver tissue is removed and examined under a microscope. It can show characteristic features of alcoholic hepatitis, such as inflammation and fat accumulation in liver cells.
Severity Scoring Systems
Once diagnosed, doctors use scoring systems to assess the severity of alcoholic hepatitis. The most common are the Maddrey Discriminant Function and the MELD score. These scores help predict outcomes and guide treatment decisions.
FAQs
Is a liver biopsy always necessary?
No, it's often not required if other tests are conclusive.
How long do test results take?
Blood test results are usually available within hours to days.
Can these tests detect early-stage alcoholic hepatitis?
Early stages may not show significant changes in tests.
Are these tests painful?
Most are painless, except liver biopsy which may cause discomfort.
How often should tests be repeated?
Frequency depends on severity and treatment response.
Beyond Diagnosis
While these tests are crucial for diagnosis, they're also important for monitoring treatment progress and guiding long-term care.
Additional References
- European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Management of alcohol-related liver disease. J Hepatol 2018; 69:154.
- Altamirano J, Miquel R, Katoonizadeh A, et al. A histologic scoring system for prognosis of patients with alcoholic hepatitis. Gastroenterology 2014; 146:1231.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic.