July/2006

ANSWER 11 =E

DISCUSSION:  

The American Gastroenterological Association recommends that patients with suspected nonalcoholic fatty liver disease be questioned carefully about alcohol use. The initial laboratory evaluation should include ALT, AST, alkaline phosphatase, serum bilirubin, and albumin levels; a prothrombin time; and diagnostic tests for viral hepatitis. When alcohol use and other causes of liver disease are excluded by the clinical and laboratory evaluation, an imaging study (e.g., ultrasonography or computed tomography) should be performed. A biopsy is rarely required.