Alcoholic liver disease is often first suspected when tests for other medical conditions show that the liver has been damaged.
Blood tests
Blood tests used to assess the liver are known as liver function tests. They can detect enzymes in your blood that are normally only present if your liver has been damaged.
Blood tests can also detect if you have low levels of certain substances, such as a protein called serum albumin, which is made by the liver. Low levels of serum albumin suggest that your liver is not functioning properly.
Further testing
If tests or your symptoms suggest that there is damage to your liver, your GP will ask you about your alcohol consumption. It is important to be totally honest about how much and how often you drink alcohol.
If you say you drink less alcohol than you do or deny drinking any alcohol, you may be referred for further unnecessary testing. This could lead to a delay in the treatment you need.
If your symptoms or liver function test suggest that you may have alcoholic hepatitis or cirrhosis, you may need further tests to assess the state of your liver. These are described below.
Imaging tests
An ultrasound scan, computerised tomography (CT) scan or a magnetic resonance imaging (MRI) scan may be carried out on your liver. The scans can produce detailed images of your liver and highlight any scarring. Some scans may also measure the stiffness of the liver, which is a good indication of whether your liver is scarred.
Liver biopsy
A fine needle is inserted into your body (usually between your ribs). A small sample of liver cells is taken and sent to a laboratory to be examined under a microscope. The biopsy is usually carried out under local anaesthetic, 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.
Endoscopy
An endoscope is a thin, long, flexible tube with a light and a video camera at one end. In an endoscopy it is passed down your oesophagus (food pipe) and into your stomach. Images of your oesophagus and stomach will be transmitted to an external screen. The doctor will be looking for varices (swollen veins), which are a sign of cirrhosis.
