A liver biopsy is an outpatient procedure that your doctor may recommend to diagnose an underlying medical condition. The procedure may cause pain, but itâ€™s usually short lasting.
Many liver biopsies take just a matter of minutes and require only local anesthesia. Itâ€™s possible to receive pain medication during the procedure if needed. After the procedure, you may need pain medication for up to a week to dull minor pain and soreness at the incision site.
You may experience pain during the liver biopsy and in the hours and days that follow it. Pain is the most common risk after a liver biopsy, but itâ€™s not long lasting and generally doesnâ€™t require extensive treatment.
What studies report
Educating yourself about the procedure may reduce concerns about potential pain.
One study examined pain levels of 118 participants who had percutaneous biopsies. It found the perceived pain of the biopsy was higher than the actual pain experienced during the procedure, particularly for women. The study concluded that patient education could help ease concerns about pain during a liver biopsy.
The amount of pain you experience may also depend on the procedure.
There are two different routes for an ultrasound-guided liver biopsy. One is the subcostal (below a rib) and the other is the intercostal (between the ribs).
One study found that both procedures resulted in the same amount of pain during the procedure, but the subcostal route caused less pain at 2 and 4 hours following the procedure.
Another study on percutaneous liver biopsies examined pain levels from participants who received two different types of anesthesia with two different procedure routes. It found that people tolerated subcapsular anesthesia better than pericapsular anesthesia.
The study also discovered that the subcapsular anesthesia performed with a subcostal approach caused the least pain and was the most comfortable.
Pain management during the procedure
Percutaneous liver biopsies are when a doctor inserts a needle into your abdomen. They are the most common, the least invasive, and do not require sedation. Local anesthesia will dull the pain during these procedures, but you may feel pressure and slight pain.
Many of these procedures only last a matter of minutes.
There are some types of liver surgical biopsies that involve general anesthesia, so youâ€™re sedated and unable to feel pain. These are still simple procedures and most people will be sent home the same day:
- Transvenous procedures require your doctor to insert a biopsy needle through the jugular vein in your neck and into the liver.
- Laparoscopic biopsies require your doctor to insert a small video camera through an incision to inspect the liver.
- Endoscopy is a newer option (if expertise is available at a center), with an ultrasound-guided liver biopsy from inside of the stomach.
Managing pain after a liver biopsy
Your pain may increase after the procedure when the anesthesia wears off. The University of Michigan reports that 1 out of 3 people get pain medication while in the recovery room following a liver biopsy.
If youâ€™re concerned about pain, you can discuss your options with your doctor or surgical team.
As a general rule, take pain medication when you begin to feel pain. Delaying medication and allowing the pain to continue can cause inflammation and make it worse.
After this procedure, the best thing you can do for pain relief and proper healing is to rest. You may check in with any family or support system if possible, decide how youâ€™re going to sleep, and put together a meal plan so that youâ€™ll be able to take it easy after the biopsy.
How long should recovery take?
You will be monitored for at least 1 hour following the procedure to ensure youâ€™re recovering as expected. Including preparation, the procedure, and monitored recovery, a typical liver biopsy can take 2 to 4 hours. Most people are sent home the same day.
You should feel like yourself immediately after a liver biopsy, but some pain or soreness could persist for a week. You may experience discomfort near the site of the biopsy, either in the right side of your abdomen or right shoulder, depending on the procedure.
Avoid strenuous activity for a few days or up to a week. Ask your doctor when you can resume daily activities.
Will you need to take time off work to deal with liver biopsy pain?
Your decision to take off time from work following a liver biopsy will depend on your schedule and the physical rigors of your work.
The procedure will take at least half a day. The biopsy itself takes a short amount of time, but preparation and recovery will take a few hours at the hospital or outpatient location. An adult will need to drive you home after the biopsy.
Keep in mind that you cannot shower for 24 hours following the procedure and that you should not lift more than 10 pounds for a week.
When to call your doctor
Severe pain after a liver biopsy may be a sign of a rare complication like internal bleeding. Call your doctor if you experience severe pain after youâ€™re sent home. Other symptoms that require immediate medical treatment include:
- abdominal pain or bloating
- redness and swelling near the incision
- bleeding at the incision
- a racing heart rate
- nausea or vomiting
- bloody or atypical stool
- a fever
You will need to seek emergency medical attention if you experience:
- chest pain
- shortness of breath
- loss of consciousness
Liver biopsies may cause some pain, but that can be managed with pain medications. Pain related to the biopsy should fade after a week. Talk with your doctor prior to the procedure to ease your concerns about pain.
Seek immediate medical help following your procedure if your pain worsens or you experience other changes to your health.
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