Diagnosing cirrhosis 

If your GP suspects cirrhosis, they'll check your medical history and carry out a physical examination to look for signs of chronic liver disease.

If your GP suspects your liver is damaged, you'll be referred for tests to confirm the diagnosis.


You may have a number of different tests, including those described below.

Blood tests

Blood tests can measure your liver function and the amount of liver damage.

A blood test may be used to measure the levels of the liver enzymes alanine transaminase (ALT) and aspartate transferase (AST) in your blood, as these will be raised if you have inflammation of the liver (hepatitis).


An ultrasound scan, transient elastography scan, computerised tomography (CT) scan or a magnetic resonance imaging (MRI) scan may be carried out on your liver.

A transient elastography scan is similar to an ultrasound scan carried out during pregnancy and is sometimes known as a Fibroscan.

These scans can produce detailed images of your liver or check liver stiffness to identify any scarring.

The Lab Tests Online UK website has more information about ALT and AST measurements.

Liver biopsy

A liver biopsy is where a fine needle is inserted into your body, usually between your ribs, to remove a small sample of liver cells. The sample is sent to a laboratory so it can be examined under a microscope.

The biopsy is usually carried out under local anaesthetic, either as a day case or with an overnight stay in hospital.

The outcome of the biopsy will confirm a diagnosis of cirrhosis and may provide more information about the cause.

Transient elastography is increasingly being used as an alternative to a biopsy in the diagnosis of cirrhosis.


An endoscopy is where a thin, long, flexible tube with a light and video camera at the end called an endoscope is passed down your throat and into your stomach.

Images of your oesophagus, the tube from your throat to your stomach, and your stomach are transmitted to an external screen, where any swollen vessels (varices), which are a sign of cirrhosis, can be seen.


There are several different grading systems for cirrhosis according to how serious it is.

One system is the Child-Pugh score, which, based on your examination and laboratory tests, grades cirrhosis from A (relatively mild) to C (severe).

An alternative system called model of end-stage liver disease (MELD) uses the results of a blood test to help identify people who need an urgent liver transplant.

Screening for liver cancer

People with cirrhosis of the liver are at a small but significantly increased risk of developing a type of liver cancer called hepatocellular carcinoma.

This means you'll be asked to have regular screening for this cancer if you have cirrhosis. Screening involves having an ultrasound scan and a blood test every six months.

Page last reviewed: 15/04/2015

Next review due: 29/04/2017