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The best way to start is to see a primary care medical provider- a Physician, Physician Assistant or a Nurse Practitioner, who can order appropriate laboratory tests, take a medical history and perform a physical exam. Laboratory is generally ordered, usually a chemistry panel known as an SMA-22 or Comprehensive Metabolic panel, which includes liver enzymes. Then, if the liver enzymes show abnormalities, and/or you have a history of risk factors for various types of hepatitis, and/or abnormal findings on exam, a hepatitis screening panel is ordered. There are a number of different types of liver diseases, and depending on lab, physical exam results, and medical history, other tests may be necessary including: imagings (CT scans, Ultrasound, MRI, others), endoscopy (using a fiber optic tube passed through the esophagus to directly view the gallbladder duct, etc) and possibly liver biopsy, or even angiography (imaging of the blood vessels in and around the liver). Interpretation of abnormal liver enzymes and/or hepatitis panel can be complicated, so it is necessary to have these results gone over with a provider, and to receive the recommended tests/proceedures. Depending on the specific disease, some are serious, some are not, some are curable, some are not.

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