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Lessons we have learned about your livers

And lessons we are still learning

Human anatomy highlighting the liver

Medcan started a liver program about one year ago. This was initiated after hearing there was growing concern among our patients about their liver status.  As a gastroenterologist and lead on our lead on our team, I was curious about whether this concern was real and how we could come up with a comprehensive approach to deal with that concern.

I didn’t want to make people worry, and I wanted to make sure we had a plan that they could trust. Our response was to devise a new multi-faceted liver assessment program that would be patient-directed, with updated imaging (liver ultrasound and FibroScan®) and extensive blood testing and historical questioning about toxin exposure, including alcohol and drugs.

Medcan patients wanted answers

Would Medcan patients want this? Yes they did! We were shocked, overwhelmed and surprised how interested our clients are with their livers! While we are used to seeing patients with gastro-intestinal (GI) symptoms and concern about GI cancers, we weren’t used to hearing from patients requesting a full-blown liver assessment.

What we discovered were younger Medcan patients, both male and female, with big concerns about their fatty livers and their drinking habits and alcohol exposure.

Are those concerns warranted?

Are we just pandering to young and neurotic people that are overweight and drink too much?  Possibly. Is this a new emerging problem with far ranging potential? Definitely.

Fatty liver is something to think about, but may not be something to worry about.  At least in most cases.

The problem is that some of these clients are going to run into trouble down the line.  We are learning more about fatty liver than ever before.  This condition of fatty liver with inflammation, not related to alcohol, (Non alcoholic steato-hepatitis or “NASH”) almost never existed when I started doing GI and liver assessments about 30 years ago.

It was an interesting rarity we would see on liver biopsy samples at “Liver Rounds” (more about that in a future article).  Today, fatty liver is the #1 cause of liver-related consultations, and the #1 cause of liver failure requiring liver transplantation, when fatty liver progresses to fibrosis and liver failure.  Personally, I have had several of my patients go on to liver failure from this, and fortunately, most have done well after liver transplantation.

Serious fatty liver is rare, but hard to predict

The vast majority of patients with fatty liver will not have any problems and will not go on to liver failure. The problem we have today is that we cannot easily predict who will and who won’t get worse. Despite many algorithms and permutations, we have not been able to confidently make future predictions on who will progress in a bad way. We have also learned that “benign” fatty liver is now associated with an increased risk of heart disease (coronary artery disease) and even liver cancer.

What we eat and drink, and how much we move will impact our liver health. So act accordingly

I think one of the greatest lessons learned is that the Medcan patients can do some things on their own.  They can self direct investigations.  They can arrange a Liver Health Assessment at Medcan. They can self direct some individual personal changes that can correct a lot of their fatty liver problem.  Losing weight and cutting back on alcohol intake is the cornerstone of treatment.

You don’t need liver biopsies or medications (more about that in another article) to reverse things. For those who need help with weight issues and alcohol use, we have on-site experts who can help direct you with plans that can guide you. We will continue to adjust and improve our liver assessments over time.

Just look after your livers in the meantime.

Learn more about the Liver Health Assessment, here. To book, please contact (416) 350-3621 or email

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