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NICE focuses on treatment and prevention of liver disease

Heavy drinkers could be sent for liver scans in a bid to detect disease early and give treatment and lifestyle changes the best chance of success.

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A draft quality standard is currently under consultation and advises GPs to refer patients for scans if males are consuming over 50 units of alcohol each week, which is the equivalent of 22 pints; meanwhile, women should be sent for cirrhosis scans if they drink over 35 units a week, which is the equivalent of 3.5 bottles of wine. This would mean that almost 1.9 million people could be referred for scans in England.

Testing for liver disease

Two tests are recommended to detect issues: acoustic radiation force impulse imaging and transient elastography. The latter is currently available at more than 120 hospitals in the UK; however, the former is newer and not as widespread.

Clinical trials, involving clinical trial assistants and a host of medical professionals, are constantly looking at ways to treat diseases, but early detection is often key to success. This is why NICE wants improvements to liver disease diagnosis.

Dr Andrew Fowell, a consultant hepatologist at Portsmouth Hospitals NHS Trust, said that early identification of liver disease is vital in ensuring the provision of support and treatment to avoid complications. He added that 10 years ago, cirrhosis would normally be diagnosed by a biopsy; now, non-invasive testing makes detection and early diagnosis much easier.

Further screening recommended

The draft guidance from NICE also expresses a desire for people diagnosed with fatty liver disease not associated with alcohol consumption to receive regular screening to detect advanced liver fibrosis and prevent cirrhosis development.

Along with this, NICE wants all young people and adults already diagnosed with cirrhosis of the liver to receive ultrasound scans twice yearly to look for hepatocellular carcinoma.

The quality standard, which is open for consultation until 2 February, also aims to support treatment improvements aimed at preventing vein bleeds in people with cirrhosis, and around 2,687 people may get treatment each year. This is the kind of treatment examined during clinical trials supported by professionals from providers such as

Liver disease is currently the fifth biggest cause of death across England and Wales, with more than 4,000 people estimated to die as a result of cirrhosis each year.

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