Clinical and biochemical assessment of symptomatic and asymptomatic liver disease

Asymptomatic abnormal liver function tests (LFTs) are common, affecting 8% of the population. They are mainly caused by alcoholic liver disease and non-alcoholic fatty liver disease, whereas jaundice is most commonly caused by extrahepatic biliary obstruction, followed by alcoholic liver disease and acute liver injury from drugs or viruses. A careful history helps to exclude non-hepatic causes of abnormal LFTs, as well as indicating a potential hepatic cause. Cirrhosis can present with ascites or jaundice, the latter being common in alcoholic liver disease as a result of added injury from alcoholic hepatitis.