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Liver (cont.)

Liver Disease Diagnosis

Damage to the liver often gives rise to telltale abnormalities in certain blood tests (suggesting liver disease), the so-called liver blood tests (for example, ALT, AST, and alkaline phosphatase enzymes). The liver blood tests often are collectively referred to as liver function tests. But, abnormalities in only some of them (i.e., elevated bilirubin, low albumin, and prolonged prothrombin time) actually reflect, at least in part, abnormal function of the liver. And, it turns out that abnormalities of the other liver blood tests may reflect the actual injury to the liver. For example, viral hepatitis can cause the ALT or AST enzymes in injured liver cells to spill into the blood stream and increase their level in the blood.

Sometimes, the pattern of liver blood test abnormalities provides a clue as to the type of liver disease. For example, an AST to ALT ratio greater than two (as long as both are less than nine times normal) suggests alcoholic hepatitis or cirrhosis of any type.

Other blood tests are more specific for the diagnosis of particular liver diseases. For example, there are antibody tests for most of the different types of viral hepatitis and immunological tests for primary biliary cirrhosis (antimitochondrial antibodies) or chronic autoimmune hepatitis (smooth muscle antibody). Additionally, there are special tests for hemochromatosis (iron-related tests), Wilson's disease (copper-related tests), and liver cancer (tumor markers).

Why does the doctor examine the liver?

The doctor examines the liver as part of the abdominal physical examination to try to gain helpful diagnostic information about a patient's liver condition. For example, the liver can be tender (painful to touch) with acute hepatitis or feel hard and irregular (bumpy) with cancer of the liver. Also, some conditions can cause the liver to enlarge (fatty liver or certain types of chronic hepatitis or cirrhosis), while others can make the liver smaller (advanced cirrhosis).

Medically Reviewed by a Doctor on 5/25/2016

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