Liver tests routinely carried out by general practitioners and other doctors are really a screening test, and have limited value in deciding the nature of any liver complaint. They really just warn us to check the liver’ rather than indicating any firm diagnosis.
To decide what the problem is requires a detailed assessment of lifestyle, drug history, personal and travel history, the history of family members’ illnesses, a detailed physical examination, and a number of additional blood tests. An ultrasound scan is done to image the structure of the liver and surrounding organs. Sometimes a biopsy of the liver is required, and there are other, specialised tests like that are occasionally needed. Very often, abnormalities found by screening turn out to have no significance, and people can be reassured. Sometimes, however, important clinical conditions like Haemochromatosis, Wilson’s disease, Alpha 1 antitrypsin deficiency, Coeliac disease, Viral hepatitis, Primary biliary cirrhosis, autoimmune chronic active hepatitis, Non-Alcoholic Fatty Liver Disease (NAFLD) or primary sclerosing cholangitis are found.
All of these can be markedly improved or cured by simple treatments. Rarely, abnormal liver function tests are an indication of a cancer, but this is usually rapidly sorted out with a scan or two, and it is a very uncommon reason for people with abnormal liver tests being sent to a liver clinician. The single most common reason for abnormal liver tests these days is obesity, with fat being deposited in the liver causing the problem.