Development of a Fibroscan service
Brighter Futures wants patients at risk of liver damage to benefit from the acquisition of a Fibroscan.
The Fibroscan can assess the degree of liver damage with a non-invasive test which is painless, quick and easy to administer.
It replaces the need for an invasive liver biopsy and allows the Hepatology Service to instigate a treatment plan promptly to prevent further damage. It is also invaluable for follow up appointments to assess scarring over time.
Intervention, regular monitoring of the condition of the liver in patients at risk of liver damage and support for patients can have a tremendous impact on patient outcomes.
In the next few years liver disease is expected to overtake heart disease as the biggest cause of premature death. Liver disease is one of the fastest developing conditions and one of the biggest killers – killing more people than diabetes and road deaths combined.
Often known as a ‘silent killer’, patients can be unaware that they suffer from liver disease because symptoms might not present until the disease is advanced. It can lead to liver cirrhosis, liver cancer and ultimately death. Liver disease is long-standing and regular follow up appointments are needed to treat and monitor the condition.
However, the liver can repair and is an amazingly forgiving organ. You can even undo cirrhosis by changing your lifestyle.
More than 90% of liver disease is due to three main risk factors: obesity, alcohol and viral hepatitis.
There are an estimated 1,400 Hepatitis C and 1,050 Hepatitis B infected people in the Great Western Hospital catchment.
Four years ago local patients with Hepatitis B and Hepatitis C had to travel to Oxford for treatment. Now all those patients are treated locally at Great Western Hospital.
Using the latest medications, today more than 90% of people with Hepatitis C may be cured.
Over the last five years, Great Western Hospital has seen a 51% increase in the number of patients admitted to hospital with alcohol-related liver disease. Liver disease is one of the main causes of death, and people are dying from it much younger as the dependency on alcohol increases year on year.
Obesity is a significant and growing problem with the majority of adults in England in being overweight or obese (64%).
It’s estimated that 1 in 3 people have early-stage non-alcohol related fatty liver disease (NAFLD) and that 20% of these will go on to develop the more serious form which can lead to cirrhosis.
There are an estimated 17,500 people with advanced form of fatty liver disease in the Great Western Hospital’s catchment population.
The Fibroscan (also known as transient elastography) is a handheld machine which assesses liver stiffness by recording how sound waves pass through the liver; the slower the sound waves travel, the healthier the liver.
In a diseased liver there may be scarring which can lead to cirrhosis – making the liver “stiff”. Fibroscans give immediate results that allow an assessment of the degree of scarring within a liver.
The equipment offers a non-invasive test that takes just minutes to perform. It also provides a means to monitor how diseases that affect the liver evolve over time.
In a single year, over 1,500 outpatient consultations at Great Western Hospital, relate to liver disease. The use of a Fibroscan machine at Great Western Hospital would allow patients to have a quick and painless test to assess the condition of their liver.
The alternative is to travel to a hospital which does have a Fibroscan (Bristol or Oxford) or to undergo a liver biopsy. A biopsy is an invasive procedure with morbidity of pain and a long hospital appointment.
Developing Great Western Hospital’s Liver Service
The Gastroenterology Department has a strategy to develop its liver service and the ability to offer timely Fibroscans is part of this. Dr Moby Joseph joined 4 years ago as a Liver Specialist and in July 2019, Great Western Hospital appointed its first full-time Liver Nurse.
At present, the Great Western Hospital is one of the few hospitals in the South West region without a Fibroscan.
Out of goodwill, between June 2017 and September 2018 Oxford University Hospitals NHS Foundation Trust allowed a member of staff to carry out Fibroscans at Great Western Hospital. During this time a total of 252 patients were assessed using a Fibroscan and then provided with robust treatment plans and diagnosis for their various diseases.
Great Western Hospital currently has a Fibroscan on trial from the manufacturer so clinicians can continue to offer this service for a limited time.
To help us to purchase our own scanner click donate now below:
The Hepatology Team urgently hopes to purchase a Fibroscan with charitable donations so that they can offer this excellent service to patients locally and spare them a painful biopsy or the inconvenience of travelling to a different hospital to be scanned.
The Fibroscan will be key in facilitating early detection of liver disease so to prevent of progression of disease into an advanced form of liver disease.