HealingWell
Search Close Search
☰

Doctor recommended that I should do a liver biopsy... does it hurt?

Support Forums
>
Hepatitis
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 5/20/2012 5:29 AM (GMT 0)
Hi all. My liver enzymes have been elevated for the past 4 months at least(that's when we first discovered the anomaly) and ultrasounds have diagnosed me as a mild case of NAFLD(a little bit of fatty deposits, everything else looks normal). Why I went for a check up is a loooooong story, but to keep the story short, it wasn't because I felt any discomfort or that anyone thought I had liver problems or anything. We discovered it by chance. Since then, we monitored them, but they remained elevated. The latest test gave me ALT level of 67 U/L(std is 0-33) and AST of 34U/L (2U/L higher than standard). They have fluctuated from ALT 100+ to 60+ during this period. We have done tests, and have ruled out Hep A, B,C, Liver cancer, Crohn's, leukemia, genetics diseases, no signs of cirrhosis either. So basically doctors have no idea what is causing this because I do not drink alcohol, nor am I obese or overweight. We have, however, found out from blood tests that I have pretty severe Vitamin D deficiency(9ng/mL). I do know that if my liver is damaged, it is possible that it was unable to convert Vit. D into its active form(or something along that lines), but is it also a reasonable guess to think that Vitamin D deficiency is a cause(rather than an effect) of my liver disease? I live in SoCal, and have no lack of access to the sun, but I am seldom out, and the rare occasions when I am out, I wear hoodies and long sleeves. So I personally feel that this guess is quite possible.

The doctor knows of my vit. D deficiency, but he made no mention of it(i guess he's quite sure that vitamin D was the effect from my damaged liver, that's why), and recommended that I do a liver biopsy.The reason I've resorted to diagnosing myself is not because I think I'm more qualified than the doctor, but it's because liver biopsy sounds sooooo scary and I'm quite desperate to get out of it. Has anyone done it, and if you had, can you compare it to a widely-known level of pain(i.e like a rubber band snap, ant bite, brazilian wax etc)? Should I get a second opinion from another doctor? Any feedback/suggestions here?

Thank you and sorry I'm a little bit long winded.
Posted 5/20/2012 5:45 AM (GMT 0)
My fiance has had 3 liver biopsies. Now, keep in mind that he has a low pain tolerance. I just asked him what, if any, the pain was like and here is what he is saying. There was a fair amount of pressure and when the 'snip' was done (sample taken from liver), it felt similar to a rubber band snap and lasted for about a second or two. And then the pressure starts releasing and there is no more pain. He was given conscious sedation for this procedure. Hope that helps. Just do what you need to do and it will be over before you know it. And yes, a second opinion is always a good thing. Have a peaceful day.

Oh, and Welcome to HealingWell!! Everyone is great here and they have a wealth of experience and information!
Posted 5/20/2012 6:47 AM (GMT 0)
Hi, Beancurd, and welcome to the forum. While your LFTs are not extremely elevated and viral hepatitis has been ruled out, a biopsy is the next logical step. It could be that your fatty liver disease has progressed. Or maybe you have AIH/Autoimmune Hepatitis.

Are you seeing a GI doc or a hepatologist? Normally, a radiologist will do the biopsy under imagining, so he can see exactly where he is going.

I've had several biopsies, starting with one in '93 when I was first diagnosed with chronic active hep C. I only got a little local anesthetic for that one--not enough and he didn't wait for it to take effect. So it felt like a sledge hammer with a knife attached had hit me. Oddly, though, I had back/shoulder pain afterwards that was really, really bad. Although I really didn't want strong meds, all they had in recovery was IV morphine and I relented and had them give it to me. I didn't feel a thing for many hours. I was admitted as a 24-hour stay and had to lie on my side with a pillow against me for 5 hours. I had a little soreness the next day, but not bad.

The next biopsy, I was unconscious, as it was done at the same time that my rt. lobe was being removed due to liver cancer. So obviously I didn't feel a thing and was also loaded with pain meds for post-surgical pain.

Then I had another one in early Feb. of this year, as my LFTs were rising after transplant. They needed to determine if this was a result of rejection or the hep C attacking my new liver. It was the hep C. This issue has again come up, and if my enzymes continue to rise, I'll be getting another biopsy.

The biopsy I had in Feb. was far better than the one in '93. For one thing, a GI doc did the first one and I think a radiologist is the better choice for this procedure. Also, they did not do imaging back then, so they were going in "blind." This time, at Mayo (different hospital), the radiologist used imaging. Also, he gave me several shots of numbing med, one of them really deep, which did elicit a yelp from me. There was just that one second of pain. The doctor waited about 5 min. and then did the biopsy and I didn't feel a thing. They kept me in recovery for observation for about an hour and then I went home. I believe they just gave me Lortab in Recovery.

I think who is doing it and how it is done make a big difference and so you will hear different things from different people. A person's pain tolerance also plays into it. But it's just a few moments of your life and will tell the doctor everything he needs to know about the status of your liver. So just do it. The worry is worse than the actual procedure.

Hugs,
Connie
Posted 5/20/2012 1:34 PM (GMT 0)
I've had 4 biopsies, 2 under sedation and 2 with a shot of xylocaine. The 2 with xylocaine didn't hurt, but when they "took" the sample, it felt like a tiny shock. Compared to some tests, a biopsy is relatively painless.
Posted 5/20/2012 2:56 PM (GMT 0)
Thank you all for the feedback. From what I've gathered so far, it shouldn't hurt that much if done right. But if it's like a tiny shock, won't you reflectively move? Eurgh, the consequences of that sounds pretty scary.
Posted 5/20/2012 3:30 PM (GMT 0)
Hi BC,

Another thought on liver biopsies. My partner had one about 9 years ago as an outpatient. Local anesthesia. the radiology guy was this huge man who started joking around with Mike when they put in the numbing stuff and then joked with him every second of the procedure. A while resting and then we left.

He has another coming up this summer a year after transplant and he is not anxious at all because his firt experience was a non-event.

Best you have the situation analyzed...so you can take action if any is indicated.

Best,
Carol
Posted 5/20/2012 9:19 PM (GMT 0)
hello everyone
I had my first biopsy , Dr. was very cauckey about how well he could do a biopsy. Really not much pain to speak of even though Dr. ^ did not get the liver , he got a lymph node a bit of stomach ,and some colon.The largest organ in the body? So we asked to have it done again by another Dr  Second Dr. got some liver. No problem.
I would like to get another one, I'm tired CT scans every 6 month.

I was easier than going to Dentist, yeah yeah

lavendar

 

Post Edited (lavendar) : 5/20/2012 3:25:31 PM (GMT-6)

Posted 5/20/2012 9:55 PM (GMT 0)
The biopsy needs to be done with ultrasound. That way they don't miss. Hitting some other organ or a blood vessel could have terrible consequences. My first biopsy was done without ultrasound and the GI tried multiple times to get a "take." It didn't hurt, but why go through that if it isn't necessary?
Posted 5/20/2012 10:36 PM (GMT 0)
It helped this last time that the radiologist demonstrated how the "biopsy gun" (for lack of a better term) would sound going off, which is pretty loud. So I was expecting that and didn't flinch when he said, "This one's the biopsy." And, as stated previously, I was numbed up well enough that I didn't feel it at all.

David, imaging is standard protocol at Mayo for a lot of things now. I wouldn't have a biopsy otherwise.

Hugs,
Connie
Posted 5/20/2012 10:39 PM (GMT 0)
Thanks for sharing, lavendar. But that "Oops, i accidentally poked the wrong organ" part sure didn't sound very reassuring! Haha. Like what hep93 and David said, guess I should make sure they're doing the biopsy with some sort of imaging. Thanks a lot guys.
Posted 5/20/2012 10:45 PM (GMT 0)
Oh, sorry. I forgot to ask, after the biopsy, is it absolutely necessary to stay in the hospital? I looked up it up, and most sources say I have to stay about 4 hours under observation, is it accurate? Anyone had any complications from a biopsy?
Posted 5/21/2012 1:09 AM (GMT 0)
No, no complications with mine. You know you have to be still, so you do it. With my last one, they kept me under observation for about 3 1/2 hours and then I went home. They warn about not doing anything strenuous. Better to just rest that day. The big problem would be bleeding.

Hugs,
Connie
Posted 5/21/2012 4:58 AM (GMT 0)
Beancurd,

I've had a liver biopsy. To me it felt like someone kicked me in the ribs, like a really hard thump.

Not that I would know from personal experience, but a brazilian is MUCH worse.

Just sayin'

Susan
Posted 5/23/2012 7:09 AM (GMT 0)
Good day everyone.
Both my biopsies were done using an ultrasound.
lavendar
Posted 5/23/2012 9:48 PM (GMT 0)
L

How was your experience? Much pain?
Posted 11/24/2012 8:42 AM (GMT 0)
Hey guys. I know it has been 6 months, but I figure that it would be helpful in the future if anyone has the same questions as I did. I did it some time back in July.

So I arrived at the facility about an hour or two early. They took some blood sample from me, to make sure my blood clotting etc was normal, I guess. Then the nurse ready-ed me up for an IV by sticking a needle through my hand. When it was finally my turn, they connected me to an IV(for pain, I think). I think they only left the IV running for a few minutes before the actual biopsy was done. I don't really know how effective the pain medication was... I just know that it made me slightly dizzy and slightly drowsy. Then, with the help of the ultrasound, the doctor stuck a needle into me, I suppose.

I said "suppose" because it didn't hurt at all. Which is very weird, because I didn't even feel a prick, the way someone would when you get an injection or get your blood drawn. I really didn't feel anything at all. The only way I knew that it was coming was when the doctor started using an alcohol swipe on my back while I was lying on my side. And then the next thing I knew was "Okay, all done!", I was so relieved that I started laughing. After that, I was pushed into their observation room, and was discharged about 3-4 hours later, I think. I didn't fall asleep despite feeling slightly drowsy the whole time.

When the pain medication went away(I'm not sure if it had an effect in the first place anyway), it felt the same. No soreness or anything. I just really didn't feel any pain during and after the biopsy.

I rate the pain a.. erm. 0

Here's my pain scale, for anyone who's interested:
Getting my blood drawn: 1/10
Eyebrow threading: 2.3/10
Brazilian wax: 5/10
Hair removal laser treatment: 7.3/10

I'm not sure if it's because the technology has improved, or that the doctor I had performed a million biopsies or what, in any case, I was lucky enough to not feel any pain at all. Oh, and as far as the results of my biopsy, he said I had mild fibrosis.. and no further treatment is needed, except that he recommends a healthy diet and exercise.

I also wanted to take the time to thank you guys for telling me your own experiences with liver biopsies. I'm planning to enter the healthcare field in the near future, and I'll make sure to lurk around this forum more. Again, just.. thank you guys for the information and the support. Knowing my diagnosis now, it seems a little silly that I was so worried about it, but I remember at that point, you guys' willingness to share your experience really did help a lot and definitely made a difference. Heck, I'm not even sure if I would've done the biopsy, so thank you!
Posted 11/24/2012 4:35 PM (GMT 0)
Thanks for sharing.
Posted 11/24/2012 7:29 PM (GMT 0)
Yes, thanks very much for coming back to share your experience. Glad to hear you didn't experience pain. I'm curious about "pain medicine" you received through IV. That's not usually done. I believe I had an IV, because they want everyone who is in the hospital (even for a procedure) to have one in case they need to give blood or meds. The only pain med I received was Lidocaine--a local. The last time, the surgeon introduced it a little at a time and went into the liver capsule, so I had no biopsy pain at all.

It's also good news that your results weren't too bad. You do need to keep to a healthy lifestyle and be monitored every now and then.

Hugs,
Connie
Posted 11/24/2012 7:34 PM (GMT 0)
Mike had a liver biopsy in the last month. he went to the day surgi center, they prepped him like BC described. They gave him something to make him sleep briefly..like they do for colonoscopy...and brought him back shortly to nap and rest. We left in a couple of hours. He complained of no pain at all.

This was his third biopsy. He has had them awake and asleep...and hadn't complained at all.

I'd think he was immune to pain BUT for seeing him writhing in pain with his pancreatitis attacks...so I know he feels pain that nothing will touch but giant doses of morphine. So I think the biopsies have not been a problem.

Carol
Posted 11/25/2012 4:15 AM (GMT 0)
My guess is that it was an IV with a tranquilizer.
✚ New Topic ✚ Reply