As a medical procedure, banding is the use of elastic bands to apply pressure and constrict, or tie off, parts of the body such as bleeding hemorrhoid or esophageal varix. Banding, also called rubber band ligation, can be used to stop bleeding elsewhere in the body, too, as in the case that it is used to treat esophageal varices. The idea behind banding is that cutting off the blood flow will allow diseased or excess tissue to die away and basically fall off the body without needing to make surgical incisions.

Doctors don’t often diagnose liver fibrosis in its mild to moderate stages. This is because liver fibrosis doesn’t usually cause symptoms until more of the liver is damaged.

When a person does progress in their liver disease, they may experience symptoms that include:

• Appetite loss
• Difficulty thinking clearly
• Fluid buildup in the legs or stomach
• Jaundice (where the skin and eyes appear yellow)
• Nausea
• Unexplained weight loss
• Weakness

There are several different scales of liver fibrosis staging, where a doctor determines the degree of liver damage. Since staging can be subjective, each scale has its own limitations. One doctor may think a liver is slightly more scarred than another. However, doctors will usually assign a stage to liver fibrosis because it helps the patient and other doctors understand the degree to which a person’s liver is affected.

One of the more popular scoring systems is the METAVIR scoring system. This system assigns a score for “activity” or the prediction of how fibrosis is progressing, and for the fibrosis level itself. Doctors can usually assign this score only after taking a biopsy or tissue sample of a piece of the liver. The activity grades range from A0 to A3:

• A0: no activity
• A1: mild activity
• A2: moderate activity
• A3: severe activity

The fibrosis stages range from F0 to F4 as per liver fibrosis scan testing:

• F0: no fibrosis
• F1: portal fibrosis without septa
• F2: portal fibrosis with few septa
• F3: numerous septa without cirrhosis
• F4: cirrhosis

Liver fibrosis occurs when the healthy tissue of your liver becomes scarred and therefore cannot work as well. Fibrosis is the first stage of liver scarring. Later, if more of the liver becomes scarred, it’s known as liver cirrhosis.