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Gastroenterology (Expert Forum)
liver pain and nausea
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
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.
liver pain and nausea
by carters8874, Mar 31, 2003 12:00AM
Hi
I am a 33 year old male - weight 210 lbs, height 6 feet.
In September, while on a dive vacation in Bali, I suffered from suspected mild decompression sickness - symptoms were joint pain, nausea and dizziness. On my return to the UK, a diving physician decided that, as 2 spells in a recompression chamber had not improved things, that I did NOT have decompression sickness at all but probably had a viral illness.
I had some blood tests done and had raised ALT (51?), raised CRP (which I was told could indicate a virus) and raised Thyroid Stimulating hormone. After a month, in November, I had more blood work done - raised ALT and TSH, CRP normal. My doctor then told me to stop alcohol for a while (I drank then around 3 glasses of win a day). I stopped drinking for a month -ALT still was raised - and thenn I started to experience the same kind of nausea/dizziness that I had had in Bali but also discomfort around my liver region and fatigue.
So,(and this is now February) I had a sonogram/ultrasound which revealed nothing but moderate fatty liver. I also had test for Hepatitis A - which I could have picked up in Bali, although I had been vaccinated against it 3 years back. Hep A test came back - I either had had it a long time back or had been vaccinated.
SO then I went to a gastroenterologist who tested me for Hepatitis B, C, autoimmune hepatitis and Haemochromatosis. all negative. His conclusion? fatty liver due to alcohol use. BUT I have a few questions
a) fatty liver I am told has no symptoms so why am I still suffering from pain in my right side and slight nausea and dizziness?
b) Could I have had Hep A even if I had been vaccinated as this did this start suddenly in Bali and my CRP up indicating a virus?
c) I now have not drank for well over 2 months - if it's mild fatty liver, when will I feel well again? Should I take milk thistle or eat certain foods?
d) could any of this be related to decompression sickness?
e)could this be related to my thyroid?
Sorry for the amount of questions but am very puzzled and want to get well again.
best wishes
chris
I am a 33 year old male - weight 210 lbs, height 6 feet.
In September, while on a dive vacation in Bali, I suffered from suspected mild decompression sickness - symptoms were joint pain, nausea and dizziness. On my return to the UK, a diving physician decided that, as 2 spells in a recompression chamber had not improved things, that I did NOT have decompression sickness at all but probably had a viral illness.
I had some blood tests done and had raised ALT (51?), raised CRP (which I was told could indicate a virus) and raised Thyroid Stimulating hormone. After a month, in November, I had more blood work done - raised ALT and TSH, CRP normal. My doctor then told me to stop alcohol for a while (I drank then around 3 glasses of win a day). I stopped drinking for a month -ALT still was raised - and thenn I started to experience the same kind of nausea/dizziness that I had had in Bali but also discomfort around my liver region and fatigue.
So,(and this is now February) I had a sonogram/ultrasound which revealed nothing but moderate fatty liver. I also had test for Hepatitis A - which I could have picked up in Bali, although I had been vaccinated against it 3 years back. Hep A test came back - I either had had it a long time back or had been vaccinated.
SO then I went to a gastroenterologist who tested me for Hepatitis B, C, autoimmune hepatitis and Haemochromatosis. all negative. His conclusion? fatty liver due to alcohol use. BUT I have a few questions
a) fatty liver I am told has no symptoms so why am I still suffering from pain in my right side and slight nausea and dizziness?
b) Could I have had Hep A even if I had been vaccinated as this did this start suddenly in Bali and my CRP up indicating a virus?
c) I now have not drank for well over 2 months - if it's mild fatty liver, when will I feel well again? Should I take milk thistle or eat certain foods?
d) could any of this be related to decompression sickness?
e)could this be related to my thyroid?
Sorry for the amount of questions but am very puzzled and want to get well again.
best wishes
chris
Doctor's Answer
by Kevin Pho, MD, Mar 31, 2003 12:00AM
, Mar 31, 2003 12:00AM
Hello - thanks for asking your question.
a) Any liver disease has the potential to cause nausea. As for pain, it is difficult to say. If the ultrasound only showed fatty liver but a normal gall bladder, then other tests to consider would be an endoscopy. Dyspepsia or GERD can also cause right upper quadrant pain. Pancreatitis or lung disease (i.e. pneumonia or abscesses) can also cause right sided pain.
b) The hepatitis A vaccine works by stimulating antibodies against the virus. Studies show that seroconversion approaches 100% after application of the vaccine. It is an effective vaccine.
c) It depends on the cause of the fatty liver. Obesity, hepatitis C, diabetes and protein malnutrition are other common causes of fatty liver. To be sure of the cause, a liver biopsy would have to be performed.
d) The symptoms may be due to decompression sickness, although it is very unlikely it will continue to be present 6 months out from your trip.
e) A raised TSH suggests hypothyoidism. That can also possibly cause your symptoms. To further evaluate this you should obtain a free T4 level to examine the acuity of the hypothyroidism.
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.
Thanks,
Kevin, M.D.
a) Any liver disease has the potential to cause nausea. As for pain, it is difficult to say. If the ultrasound only showed fatty liver but a normal gall bladder, then other tests to consider would be an endoscopy. Dyspepsia or GERD can also cause right upper quadrant pain. Pancreatitis or lung disease (i.e. pneumonia or abscesses) can also cause right sided pain.
b) The hepatitis A vaccine works by stimulating antibodies against the virus. Studies show that seroconversion approaches 100% after application of the vaccine. It is an effective vaccine.
c) It depends on the cause of the fatty liver. Obesity, hepatitis C, diabetes and protein malnutrition are other common causes of fatty liver. To be sure of the cause, a liver biopsy would have to be performed.
d) The symptoms may be due to decompression sickness, although it is very unlikely it will continue to be present 6 months out from your trip.
e) A raised TSH suggests hypothyoidism. That can also possibly cause your symptoms. To further evaluate this you should obtain a free T4 level to examine the acuity of the hypothyroidism.
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.
Thanks,
Kevin, M.D.
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