NICE Suggests Tests For Early Detection Of Liver Disease 

General practices and community health services have urged people who drink excessively to have early liver scans, in order to catch liver diseases at an early stage. The researchers’ definition of excessive drinking is; men who drink more than 22 pints of beer and women who drink more than 3.5 bottles of wine a week. These recommendations were advocated by the National Institute for Health and Care Excellence (NICE) in a new draft quality standard.

The draft quality standard is being released for consultation until February 2017, and the final standard is aimed to be released in June 2017. NICE has suggested that individuals with a risk of cirrhosis should be offered non-invasive testing, in order for early detection, treatment and support.

Individuals who drink excessively are at a higher risk especially those who have hepatitis B or C, alcohol related liver disease, or non-alcoholic fatty liver disease with advanced liver fibrosis.

NICE quality standards are priority based recommendations, and not compulsory regulations, set to assist healthcare providers reach betterment in terms of the quality of healthcare they provide. These standards will give health and social care systems a good starting point for planning and implementing new policies and services.

Andrew Fowell, consultant hepatologist at Portsmouth Hospitals NHS Trust and a member of the committee that created the quality standard, said, “Identifying people who are at risk of liver disease and offering them non-invasive testing to diagnose cirrhosis is key to ensuring they are given the treatment and support they need early enough to prevent serious complications.”

deputy chief executive of NICE Gillian Leng added that since many individuals with liver disease do not present symptoms until it is too late, early detection is crucial, since basic lifestyle changes or simple treatments can be adequate for the liver to heal.

Fowell further commented, “Ten years ago, diagnosis of cirrhosis would often require a liver biopsy, but now with advances in non-invasive testing it is much easier for patients and health professionals to make a diagnosis.”

The quality standard document suggests use of transient elastography, which utilizes ultrasound technology and low frequency waves to measure liver fibrosis, in individuals who show risk factors for cirrhosis. This scanning technique is operational at more than 120 UK hospitals.

Liver fibrosis is the buildup of scar tissue accompanied by an overabundance of extracellular proteins in the liver. Because scar tissues are not able to perform normal liver tissue function, it increases the stress on the remaining tissues of the liver, ever increasing the area covered by scar tissue. The US Centers of Disease Control and Prevention (CDC) states that per year the number of deaths caused by liver diseases induced by alcohol are 18,146.

Liver Fibrosis is the gateway to several disorders of the liver. Primarily, fibrosis leads to cirrhosis, a condition where the scar tissue has spread so extensively in the liver that the organ is unable to perform its function. The outcome can escalate up to hepatocellular carcinoma. Because the disease is so progressive, in several circumstances the patient has to get a transplant.

As there is no proper treatment for liver fibrosis yet, one should be cautious of the amount of alcohol consumed by him or her, which according to the UK government’s guidelines are same for both men and women. However, the Dietary Guidelines for Americans suggests that men can have up to two drinks per day while the safe amount for women is one drink a day. Of course, they explicitly mention that if you don’t drink at all, you shouldn’t consider starting to drink.

NICE also suggests a relatively recent ultrasound based imaging technique called acoustic radiation force impulse imaging, for individuals suffering from non-alcoholic fatty liver disease or advanced liver fibrosis. Availability of this imaging technique is limited and varies around the country.

American Dietary guidelines 2015 has suggested the proper guidelines for consuming alcohol. They have formulated drink equivalents to evaluate the amount of alcohol that can be consumed within healthy limits.

One alcoholic drink-equivalent is described as containing 14 g (0.6 fl oz) of pure alcohol. The following are reference beverages that are equal to one alcohol drink. These measurements are 12 fluid ounces of regular beer (5% alcohol), 5 fluid ounces of wine (12% alcohol), or 1.5 fluid ounces of 80 proof distilled spirits (40% alcohol).

Packaged alcohol, such as canned beer or bottled wine and cocktails or mixed beverages such as margarita, rum and soda, mimosa, sangria can differ in alcohol content. Due to this purpose, it is vital to determine how many alcoholic drink-equivalents are in the beverage so that people can cut off their consumption accordingly.

Table A9-1 lists reference beverages that are one drink-equivalent and provides examples of alcoholic drink-equivalents in other alcoholic beverages.

Therefore, if a person follows these guidelines properly and conduct early tests when they detect any unfavorable symptoms, their liver health and overall well-being will be out of harm’s way indubitably.

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