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Gastroenterology (Expert Forum)
Ultrasound showed enlarged liver....what symptoms can result...
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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Ultrasound showed enlarged liver....what symptoms can result...
by Klinktc79, Jul 05, 2006 12:00AM
I am a 27 year-old male, 6'0", 250 lbs. For the last 3-4 years, I have had periods where I felt fatigued, malaise, and generally under the weather. These would last 2-3 months, and then go away for up to a year. I have been to numerous doctors numerous times, with no diagnosis to speak of. The only lab test which have consistently been off is my ALT, which has only gotten as high as 68, and most recently was 45. A month ago, my upper right abdomen began aching, so after a few weeks, I went to my GP. He ordered an abdominal ultrasound which showed an enlarged liver, with all the other organs being fine. He told me that I have fatty liver, and I needed to change my diet and stop drinking. He also told me that he saw no reason for me to have aching in my right abdomen.
I have several questions:
1) Can fatty liver result in light abdominal aching?
2) Can fatty liver, over a long period of time, result in symptoms such as malaise and fatigue? If so, is this uncommon?
3) Given that I had an ultrasound and normal liver enzymes (other than the slightly elevated ALT), how likely is it that the enlargement of my liver is caused by something more sinister, such as cancer? Would the ultrasound have picked up on something like that?
4) I have noticed (and thought back to) that when I drink, my abdomen seems to hurt more that next day than normal. Is this consistent with the diagnosis of fatty liver?
5) Are there any additional steps that should be taken beyond my GP's recommendations, such as biopsy, CT scan, etc.?
Thanks in advance for the help,
Tim
I have several questions:
1) Can fatty liver result in light abdominal aching?
2) Can fatty liver, over a long period of time, result in symptoms such as malaise and fatigue? If so, is this uncommon?
3) Given that I had an ultrasound and normal liver enzymes (other than the slightly elevated ALT), how likely is it that the enlargement of my liver is caused by something more sinister, such as cancer? Would the ultrasound have picked up on something like that?
4) I have noticed (and thought back to) that when I drink, my abdomen seems to hurt more that next day than normal. Is this consistent with the diagnosis of fatty liver?
5) Are there any additional steps that should be taken beyond my GP's recommendations, such as biopsy, CT scan, etc.?
Thanks in advance for the help,
Tim
Doctor's Answer
by Kevin Pho, MD, Jul 05, 2006 12:00AM
, Jul 05, 2006 12:00AM
To answer your questions:
1) Fatty liver can result in abdominal pain.
2) It may be possible for fatty liver to result in malaise and fatigue. However, you may want to inquire about other causes of these symptoms.
3) A normal ultrasound would make liver cancer less likely. A CT scan can be considered if this is suspected.
4) Alcoholic hepatitis can lead to this symptom. If there is an association between the pain and drinking, you may want to discuss with your personal physician whether abstaining from alcohol is an option.
5) A biopsy is normally not indicated for an ALT of that level. A CT scan can be considered, as well as referral to a GI specialist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
1) Fatty liver can result in abdominal pain.
2) It may be possible for fatty liver to result in malaise and fatigue. However, you may want to inquire about other causes of these symptoms.
3) A normal ultrasound would make liver cancer less likely. A CT scan can be considered if this is suspected.
4) Alcoholic hepatitis can lead to this symptom. If there is an association between the pain and drinking, you may want to discuss with your personal physician whether abstaining from alcohol is an option.
5) A biopsy is normally not indicated for an ALT of that level. A CT scan can be considered, as well as referral to a GI specialist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
You should get tested right away. I strongly advise you to stop consuming alcohol,start eating a good liver friendly diet and get some exercise.An enlarged liver is nothing to ignore.
Fatty liver can be controlled through diet and exercise and it can get worse if you ignore it. Google around and do a little reading on end stage liver disease, fatty liver and cirrhosis that should scare you into action. ifestye changes are in order. If you do have hep b or c, which is very possible, (milions of people have it and have no risk factors for it) and you continue to drink, the consequences can be dire. Get tested.
Up to a point your liver can heal itself so you can do something about it. Start today.
The only true measure of liver damage is a biopsy. I would encourage you to get one if your doctor feels it is warranted.
Discuss it with him. You might want to consult with a liver specialist ( Heptologist)
scans and CT's and enzyme readings and other blood indicators can offer some information, but to really KNOW your liver condition, you have to have a biopsy.
By the way, what were your bilirubin readings? How about your platelet count? Do yourself a favor if you haven't already and get copies of ALL your testing results so you can begin to educate yourself and learn what they mean.
Remeber, YOU are in charge of your own medical care, your doctors are there to assist you and advise you but ultimately you are in charge. Educate yourself about liver disease so you can speak intelligently with your doctor and know what questions to ask.
Keep in mind you CAN do something about it and hopefully liver damage, if any, is still in the reversible stage.
Remember ANY alcohol at all on a stressed liver is not advisable. What you eat is very important too, you already have fatty liver, you need to reexamine your diet carefully and if you are not getting regular exercise, you might want to do that too.
I view this as my body finally telling me it is time to grow up and stop abusing it. It was going to happen at some point. As far as drinking, I am done. It has never been something I have to do. I only drink socially, and I enjoy the taste of a nice coke better than any alcohol.
The real problem is going to be diet. Man how I love food :)
Luckily, I don't think my liver is badly damaged at this point. The last liver functions were completely normal, and he said it was "slightly enlarged". I think I should be able to let it repair itself with good diet and abstinance from drinking.