Liver Disease & Cirrhosis Clinic

Liver clinic

Why liver disease is easy to miss

The liver has a large reserve. It can be substantially damaged while you feel entirely normal, which is why liver disease is so often discovered by accident — on a routine ultrasound, an insurance medical, or a blood test done for something else. By the time symptoms such as swelling of the abdomen, confusion or vomiting of blood appear, the disease is usually advanced.

That is the reason the Liver Disease and Cirrhosis Clinic exists: to identify liver disease early, stage it accurately without unnecessary biopsy, treat the underlying cause, and monitor for complications before they become emergencies.

Conditions managed in this clinic

• Fatty liver disease (MASLD / NAFLD)
• Metabolic and diabetic liver disease
• Chronic hepatitis B
• Hepatitis C
• Alcohol-related liver disease
• Cirrhosis and portal hypertension
• Autoimmune hepatitis
• Drug-induced liver injury
• Abnormal liver tests of unknown cause
• Inherited liver disorders (assessment and referral)

How the liver is assessed here

The assessment is staged, so that only the tests you need are done:

• History and examination — alcohol intake, medicines, family history, weight history, risk factors for viral hepatitis, signs of chronic liver disease.
• Blood tests — liver function, complete blood count, coagulation, albumin, viral markers, and screening for other causes.
• Abdominal ultrasound — liver texture, bile ducts, spleen, and fluid in the abdomen.
• FibroScan — non-invasive liver stiffness and fat measurement, which in most patients replaces the need for a biopsy.
• Upper GI endoscopy — to look for varices in patients with cirrhosis or advanced fibrosis.
• Liver biopsy — only where non-invasive tests leave genuine diagnostic uncertainty.

Cirrhosis: what it means, and what it does not

Cirrhosis means the liver has developed scarring that changes its structure and can impair its function. It is a serious diagnosis and it is usually irreversible — but it is not the same as a diagnosis of imminent death, and it is not a reason to give up on treatment. Much of cirrhosis care is compensation: removing the ongoing cause of injury, protecting the liver from further harm, and screening for and preventing the complications that cause the most trouble.

Most cirrhosis follow-up here therefore focuses on:

• Treating the underlying cause — antiviral therapy, alcohol abstinence, weight and metabolic control.
• Regular surveillance endoscopy for varices, so they can be treated before they bleed.
• Monitoring for fluid accumulation, infection and kidney function.
• Six-monthly ultrasound surveillance for liver cancer, in line with standard practice.
• Nutrition, vaccination and safe medication review.
• Discussion of transplant assessment and timely referral where this becomes appropriate.

Hepatitis B and C in brief

Chronic hepatitis B is manageable and usually controllable with antiviral medication, but requires long-term monitoring because treatment is not always a cure. Hepatitis C is different: modern direct-acting antiviral tablets cure the great majority of people in about 8–12 weeks. More detail is in our patient education article on hepatitis B and C.

Fatty liver disease

Fatty liver is now among the most common liver conditions in India, closely linked to weight, diabetes, blood pressure and lipid levels. In its earlier stages it responds well to gradual weight loss, dietary change and control of diabetes. The important part is identifying the minority of patients in whom fat has already progressed to inflammation and fibrosis, because those patients need closer follow-up. FibroScan is the main tool used here to make that distinction. See also our article on fatty liver disease.