Should your liver be checked even if you have no symptoms? In the show The advice of Doctor Kierzek, broadcast on ICI, the chronicling doctor recalls a simple answer: some profiles have an interest in talking to their doctor about itwithout reducing the risk to alcohol.
Why liver disease is often detected late
Dr Gérald Kierzek describes the liver as a real internal factory: it filters, transforms, stores and manufactures. Its key point is very concrete: this organ can function for a long time without being talked about. This is what explains that chronic liver diseases can progress without obvious signssometimes to an already advanced stage.
The French RESONANCE data, taken up by the French Association for the Study of the Liver, go in the same direction: a significant proportion of chronic liver diseases are identified late. The AFEF mentions 44% in its 2026 press release, while a scientific abstract published in 2025 reported 41.3% of incident cases identified immediately at an advanced stage. These figures do not mean that every liver abnormality leads to a serious complication, but thatearlier detection allows action before certain complicationsdepending on the cause and stage.
To learn more about the subject without alarm, you can also consult our article on the signs of liver disease.
Alcohol, hepatitis, metabolism: profiles not to forget
In the column, the presenter underlines a common prejudice: a diseased liver would necessarily be linked to alcohol. Dr. Kierzek clearly corrects him. Alcohol is one of the possible causes, but he also cites viral hepatitis B and C and metabolic fatty liver disease, sometimes called fatty liver disease.
The major risk factors are therefore:
- Alcohol consumption, which remains a risk factor for the liver;
- Viral hepatitis B and C, which can become chronic;
- Metabolic factors, such as diabetes, being overweight, high waist circumference, high cholesterol or hypertension.
According to Health Insurance, metabolic fatty liver affects approximately one in six adults in France. This does not mean that a person with diabetes, overweight or high cholesterol necessarily has liver disease. This is a known association, which warrants discussing it with a healthcare professional.
The practical advice formulated by Dr Kierzek is targeted: in case of diabetes, overweight, large waistline or high cholesterol, ask your doctor if a liver test is relevantespecially if it has never been done. For hepatitis, our file on hepatitis screening can help to understand the issues, without replacing medical advice.
On alcohol, Dr Kierzek recalls the benchmarks cited in the show: no more than two drinks per day, no more than ten per week, with the idea that not drinking further reduces exposure to risk. For people dependent on alcohol, pregnant or suffering from a chronic illness, the discussion must take place with a caregiver, without sudden unaccompanied cessation.
FIB-4 and FibroScan: two tools to discuss with the doctor
Dr Kierzek emphasizes a reassuring point: the first sorting can be based on simple tools. The FIB-4, for example,
is not an exam in itself : this is a score calculated from common data, including age, AST/ALT transaminases and platelets. The European EASL-EASD-EASO 2024 recommendations describe a step-by-step strategy in people at cardiometabolic risk: blood score first, then additional examination if necessary.
If the result justifies it, the doctor may suggest a FibroScan. As Dr. Kierzek explains, this device is similar to an ultrasound and is used to measure liver stiffness. In practice, FibroScan should not be presented as a test to be done systematically by everyone : it is part of an identification process, after evaluation of the medical context. Our article on screening for liver fibrosis details these concepts.
In Strasbourg, current events also provide a concrete opportunity to talk about it: on October 7, 2026, the AFEF is organizing a free day of awareness and screening at the Palais des Congrès, from 10 a.m. to 5 p.m., on the sidelines of its 99th Days. The announced program includes screening for hepatitis B and C, HIV and an assessment of fibrosis by FibroScan. For others, the good reflex remains to ask the question to your doctor during a usual consultation.