do i really need a liver biopsy

hi everyone, i am a 52 yr old female with a history of diabetes and crohns disease, my gastro did a series of tests 2 yrs ago because of my crohns which also showed a diffuse fatty liver with no evidence of fibrosis, at the time my liver enzymes fluctuated slightly, since then i have been on statin drugs, and several other meds that can cause liver inflammation, my recent blood tests showed slightly elevated liver enzymes, now dr is freaking out and wants to do a biopsy to look at fatty liver, all other liver tests are normal except for alt, i dont really see the need for a painful biopsy, i know how they are my brother has had several due to liver translplant from hep c got in vietnam he was a medic, dr just says it is precautionary to  but i dont see the need for painful procedure when dr knows i have a fatty liver, diabetes, i have been taken off the drugs now that can cause liver inflammation, i just dont want to go through with such a painful procedure , any thoughts

When a liver bx is ordered, in your case, the doc is trying to assess the severity of your FLD. A liver bx can help your doc find the reason for your FLD, and help rule out NASH. As I've said before, a liver bx should not be painful, but many times it is. Talk to your doc before you have the procedure and ask if he will administer any sedatives or pain killers. Many clinics will administer a benzodiazapine to the point the the drug puts you to sleep or induces amnesia for the entire procedure. Xylocaine is usually used to numb the skin all the way down to the capsule, and the liver has no nerves in it, so you wont feel pain in your liver. You might, however, feel referred pain (giving your awake).

Well, Gil, I guess everyone responds differently, but the biopsy hurt like hell for me, and they would give me NOTHING until AFTER the biopsy. The last liver biopsy I had was just in May, while I was under general anesthesia for excision of the right lobe of my liver. They biopsied the left lobe, and of course I felt nothing and wouldn't have known if I hadn't been told.

I see you are new to this forum. Welcome! You might want to go back and read some previous threads where this and other common concerns have been discussed previously.

Connie