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Fatty Liver
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Fatty Liver

About 7 months ago, I went to my internist suffering from epigastric pain. My internist, who is also my best friend, ran a complete physical on me. The whole nine yards. Two days later he called back and said that everything was just fine except my liver enzymes were slightly high. ALT 70 and AST 58. Their lab scale is 0-59. He was not real concerned about this, but he did want to find out why I was having epigastric pain, so the next day we did an ultrasound of my belly. I had significant fatty liver. I immediately got nervous. I unfortunately have been a very heavy beer drinker since my feshman year in college. I'm 32. So, for 15 years. I'm an avid jogger and kind of thought it would all balance out. This is not the case unfortunately. I would not say that I drank every day, but I drank very heavy when I drank. Needless to say, I have not drank since the day, I got that news. And after studying the liver on the web for the past 7 months, I never will. My enzymes were back in the low normal range within 3 days. And my fatty liver disappeared within 3 weeks. My uncle is a radiologist and he ran an MRI and an ultrasound on me. He said, I was fine just lay off the beer. The internet is full of so much information, I started worrying about my liver. Fibrosis was my main concern and still is. The imaging test that I have had do not show microscopic scarring. My internist as well as my uncle have told me that a biopsy is out of the question. I do not have any other concurrent damage occuring like HEP C. They said that my liver is perfectly fine. My other liver panels have been OK also. Bilirubin( direct and indirect, PT, albumin, ect. My stomach pain turned out to be gastritis. I've had every test in the world run on me to find this out. Hida-scan,barium swallow, and finally and upper endoscopy that revealed gastritis. It has passed and I feel great except for my anxiety and guilt from drinking all those years. I woory because I'm marrying a beautiful girl in May and want to live a long healthy life with her. Do you concure with my internist. He say's I'm very healthy for my age. I run 10 miles a day and have since I was 17. Even with all the drinking. He said a biopsy might show come minimal fibrosis, but it was not compromising my liver and was of absolutely no significance. My uncle, the radiologist agrees. He says--"GET OVER IT"    Can someone have mild fibrosis and live a normal lifespan? I probably do not even have fibrosis, but what if I do. Your in put would be Appreciated----  AL
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Hello - thanks for asking your question.

I would agree with your internist and your radiologist uncle.  You have had an ultrasond and MRI which your uncle said was fine (i.e. no more fatty liver).

If your liver function tests (AST, ALT, TBili, GGT, PT etc.) are completely normal, then I would not be worried.  To give yourself further peace of mind, you may want to run heptatis screens to ensure you do not have concurrent liver disease.

The definitive test would be a liver biopsy, however in the light of a normal ultrasound, MRI and liver function tests, I do not think it is necessary.

It is possible to have mild fibrosis and live a normal lifespan - if you continue to be concerned, then periodic liver function tests can monitor any decrease in liver function.  

Congratulations on quitting alcohol - that is probably the best thing you could have done in light of your previously elevated enzymes and fatty liver.

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.
35 Comments
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Hello,  I have NASH (Nonalcoholic steatohepatitis).  I was diagnosed after extensive testing, including oral glucose tolerance tests, blood tests, and liver biopsy at the National Institutes of Health in Bethesda, MD.  After being diagnosed with NASH, I then participated in a Clinical Trial at the National Institute of Health to test a drug for this disease.  I have completed the clinical trial and am now participating in 6 months of follow up visit with the docotrs at NIH.  This is a newly recognized disease and a lot of doctors are not up to speed with the current research.  I would imagine that most doctors are quite busy and don't have time to read the in depth articles on current research.  NASH is a fairly mild disease and it is not on the top of the doctor's list of things to worry about.  So it is best to educate yourself and learn to take care of yourself.  I am glad that you have given up the alcoholic beverages.  Just remember that everything that you eat goes through your liver.  I was very careful about what I ate during the year that I was participating in the clinical trial and the biopsy I had at the end of the trial showed that I had less fibrosis.  So if you take care of yourself you can improve your "liver health".  My liver enzymes have dropped back into a normal range as well.  The best place to read about the liver on the internet is www.liverfoundation.org.
  I'd be glad to discuss "fatty liver" with you again, if you like.
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I just get confused with the fine line between fibrosis and cirrhosis. What foods are bad for the liver?  JIGGER
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alcohol
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Is it possible for a relatively healthy 26-year old woman to drink herself to death if she's only been a moderate/heavy drinker since the age of 18? (I ask because, in short, my mother had an alcohol problem (in part due to spousal abuse)... died at the age of 26.) I would like to know if it's possible or even remotely likely...
I did get the autopsy records, but as I do not have a medical background, it reads a little difficult. I had another relative bring them to work and it would seem that she may have had some sort of hepatitis. Is there a hepatitis that is not passed along to children/spouses and that she would have been likely to contract.... She lived in New England for most of her life, was a housewife... did no needle drugs... I would be most thankful for your assistance. :)
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Alcohol is one thing that the doctors are sure is bad for your liver.  Tylenol is also bad for the liver if you take more than the recommended dosage or combine it with alcohol.  There are some other drugs that are known to be bad for the liver and they are drugs that are used for epileptic patients to control seizures.  
   A person can have this nonalcoholic steatohepatitis for years and not have symptoms except for fatigue and mild pain in the right side under the ribs.  If a person was abusing alcohol it possibly could aggravate the liver and make the condition worse. But since she was so young when she died I have my doubts as to whether the liver disease could have caused her death.  
   The word hepatitis simply means inflamation (inflammation).  I imagine there are many many people walking around with hepatitis and don't even know it.
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Do most heavy drinkers develop fatty liver or only an unfortunate few? Why did mine go away so fast? Is that a good sign?
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Here are a few sentences from a book called "Understanding Hepatitis"--Acute alcoholic hepatitis resolves in time in 90 per cent of patients when alcohol is withdrawn.  Liver tests become normal in about six to twelve weeks, but liver biopsy shows that the acute process may take six to twelve months to completely resolve.
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My question is if I did have some minor fibrosis in my liver, will my liver continue to function properly as long as I take care of it. I was not diagnosed with alcoholic hepatitis. I had fatty liver. My enzymes were not in accordance with alcoholic hepatitis.
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My question is if I did have some minor fibrosis in my liver, will my liver continue to function properly as long as I take care of it. I was not diagnosed with alcoholic hepatitis. I had fatty liver. My enzymes were not in accordance with alcoholic hepatitis.
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Yes, I think so.

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Hi everyone. I am new to this forum and have been trying to find some answers to my questions, but what I read (the abbreviations and terms are greek to me)and try as might I can't find anything close to what I am wanting to know. So, if anyone cares to shed some light I would be most appreciative. I recently had a liver biopsy cause my LFT's are too high. The radiologist did mine and although they said I wouldn't feel anything....it hurt! They gave me a mild sedative, but it was just too mild cause I felt everything. Anyway, I got my results back and all my GI doc said was that I needed to see a hepatologist. I haven't a clue except that they ruled out hepatitis. Here are my results I have calcified granulomas are seen in the liver and spleen. I have severe steatosis with mild periportal and lobular activity with portal and periportal fibrosis without evidence of bridging. Can someone please tell me what this all means. I know I have fatty liver, but I do not drink or take drugs...never have. So can someone please explain and also tell me how serious this is and what will the hepatologist be doing? I know that having fibrosis of the liver is not good...but please someone tell me just how serious this is. Sorry for the length of this post..and thank you in advance.
Ellie
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Could someone please explain to me what fibrosis is. I do not understand it fully. Can a liver continue to work with a little bit of fibrosis. I'm a recovering alcoholic. I have not drank in 7 months. My liver enzymes were slightly high AST 70 and ALT 58. Their lab is 0-60. Within one week of abstinence my enzymes were normal and have remained. My internist said I'm fine. I'm very active. I run 8-10 miles per day. I just drank alot for many years. About 12 years. Anyone have any comment? My internist refuse a biopsy. We did an MRI in November thta showed no fat, the report read normal MRI of Liver.
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Fibrosis is scarring I believe.  If it's bad, I believe it would be called Cirrhosis.



I thought I had PSC (I still don't know). I was told I have Fatty Liver, diagnosed by CT scan. I have a past history of UC that was cured 30 yrs ago, & gallbladder removal 15 yrs ago. I get intermittent itching all over & RUQ tightness, like a finger is pushing on the area (adhesions maybe?) But my labs are all good. Alk Phos - 54, ALT - 41, AST - 26, T Bil - 1.0, ALB - 5.0, GGT - 22, PT - 10.6. Sometimes I get a RUQ ache. I researched my labs back 10 yrs & they were always good. Any ideas from anyone? Does Fatty Liver cause itching??
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Jigger, You are FINE!!  There most likely is nothing wrong at all with your liver. I doubt you have any fibrosis at all. You don't even have to stop drinking. Just be sensible & drink in moderation. Get on with your life & forget it, you're good to go.
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I probably don't have any fibrosis. I just wonder if I do will it cause me problems in the future. I'm getting married in May and just worry. I feel guilty for all the beer I drank!
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Don't feel guilty, those were you "party years". Now it's time to move on, into a new part of your life. If you drink from now on, drink sensibly, or not at all. If you have mild fibrosis (which I highly doubt) it shouldn't affect your lifespan, unless you continued to abuse your liver. BTW, Take Milk Thistle for your liver health. I use the "Solgar" brand.  Pat
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Thanks Pat,

  I have been taking milk thistle and drinking some sort of liver detox tea. I realize those are your party years, but you read about so many people on the web dying of cirrhosis at 30 or even younger. It is scary. I was a heavy drinker. Not every day, but when I did I did it up. I would love to drink in moderation, but I'm not sure I can. I can not get my doctor to give me a direct answer to the whole fibrosis thing. he just say's your fine!! "If you have any it is not significant"  JEFF
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Pat:

A right upper quadrant ache and tighness could be anxiety. I also experience this. Is it in you rib cage area? Possibly costocondritis. I have this from anxiety about my liver. Fatty liver does not typically cause itching or pain. It can cause pain, but that would be in an extreme case. And the pain is usually a dull ache.  JEFF
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It's right below my ribcage by my liver. I was thinking adhesions from gallbladder surgery. Who knows

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That is possible. Thank You for your words of encouragement. I hope your pain goes away. God Bless, JEFF
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Same to you Jeff. Good Luck in your future, & early congrats on your upcoming marriage.  Pat
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You should go to the liver foundation website and do some reading there.  www.liverfoundation.org.  
How old are you? Are you overweight?  Does diabetes run in your family?  I will try to answer some of your questions if you post again.  

   roxnsox
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Hi and thank you for responding.  I am 47 and about 30 lbs overweight.  I am borderline diabetic, but that was based on one score when I was checked in the doctor's office and not a fasting score.  I have checked my blood sugar at home daily since and it is usually between 96 and 110..sometimes 116.  I have one uncle with adult diabetes but he controls by eating properly.  Can you tell me what the life expectance is for someone with possible stage 2 fibrosis of the liver.  Mine is most likely due to an immune disorder.  I have been tested for everything else and negative (Hepatitis, AIDS, etc.) Can you tell me about the stages and their time frames especially about the life expectancy.  I have not been told I am stage 2, but I read someone in here on one of the posts that when fibrosis is present, without bridging it is considered stage 2.  I can't get in to the Hepatoligst for another 6 weeks and I would like to know as much as possible before I do see him, so I knoow the appropriate questions to ask.  Thank you for any info you can provide.
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Hello....I just had a CT Abdomen/Pelvis performed with a mobile unit called Scan2000.  I received the results today and not sure what to make of it they are as follows: 205 cm. of decreased attenuation in left lobe of liver-may be focal fatty infiltrate or hemnagioma-follow with ultrasound.  Iliac artery calcification. Lets start with that I am only a social drinker.....once every few months or so.  I have had a lot of female problems last year and underwent a partial hysterectomy with rectum repair, bladder tuck and vaginal repair.  I also have asthma and was taking a medication called advair (was told that was the drug serevent doing that) that I have recently stopped due to feeling so bad all the time and pain in my muscles all the time and a pain in the left lower back under rib cage.  Can you please tell me what this means?  Thanks
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   I am about 6 years older than you and have had 2 liver biopsies.   The doctors didn't discuss fibrosis stages with me.  I haven't spent a lot of time researching them.  So I can't really tell you about the stages of fibrosis for fatty liver.  There is a lot of discussion on the hepatitis forum section about stages but I believe those people are suffering from viral hepatitis (Hepatitis A, B or C).  They told me that my prognosis is good.  I can't remember exactly what they told me.  Something like only 10 per cent of liver disease patients progress to cirrohsis.  So if you take care of yourself you can live a long life.  I certainly plan to.  
   I cut all hydrogenated fats and oils from my diet.  It has made a big difference in how I feel.   A low fat diet is essential for anyone with "fatty liver".
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if u don't feel like u can drink in moderation, DON'T.  Take it from an recovering alcoholic---> ME,,,alcoholism is a baffling, insidious disease and if u start trying to drink in moderation u will eventually, i assure you, begin the heavy drinking binges again,,,,good luck Jeff,,,,Brad.
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I appreciate your input. I can not even imaging drinking again. My drinking was so odd. I did not drink every day, I just could not stop once I started. I feel it is best if I leave the stuff alone. Thanks JEFF
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you are 32, i am 44,,,at 32, i only drank fri & sat nights but VERY HEAVY,,,,,,,a fifth of bourbon,,,,and then it progressed to fri, sat, sun ( man mon. morn was a ***** ),,,by say, 38, it was thurs, fri, sat, sun...by 42,,,,7 days a week,,,,,,,thought i had a handle on it,,,,NOT,,,,stuff will nail your *** without u even knowing it,,,,I had the fatty liver thing too,,,,in A.A.,,,You would not believe how many people have had "the sharp pain under the rib-cage",,your liver will return to normal,,,you had a relatively short time before your pain stopped,,,it took me 3 months,,,,could only lay on my stomach in bed,,,,,what a *****,,,glad it's over!!!,lol,,,take care , Brad
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FYI, You don't get fatty liver from eating fatty foods. Just thought you'd like to know.
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I never had pain under my ribs. The pain that I had was acute gastritis. Two weeks of aciphex took care of that. I'm glad you are doing well. It is a hard adjustment to remove alcohol from your life. It becomes such a good friend.  JEFF
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Yes, I am aware that you don't get fatty liver from fatty foods but the doctors and dieticians always tell you to cut back on the fatty foods.  I did and I feel much better.  
   I was diagnosed by the doctors at the National Institute of Health in Bethesda, Md and have spent the past year going to the liver clinic every four weeks for check-ups and follow-ups.

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On a recent CT, it showed a 10 mm cyst, i have been having pain under my lower right rib cage. It isnt pain, just a dull soreness when i raise my right arm to reach for something. My liver enzymes were slightly elevated, but now are well within normal range. On my recent ultrasound, it showed that i have fatty liver, but i dont know to what extent. I am worried that this may turn into fibrosis and then cirrosis (cirrhosis). Worry doesn't help, so i am trying not to. Is there any way to know to what EXTENT, that the fat has infiltrated the liver?  THe strange part of this is i have only been a social drinker (holidays, birthdays) etc. Any comments would be appreciated.
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Fat by itself is not thought to lead to fibrosis. There is usually another trigger. That is inflammation. Have you had hepatitis screens. I had fatty liver from drinking to much. It went away in 3 weeks. Pain in the liver area could be lots of things. Epigastric,gallbladder. Go see a good gastro-doc.
                  JEFF
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There are many different kinds of "fatty liver".  Plain fatty liver has no inflamation (inflammation) with it.  Fatty liver with inflamation (inflammation) is "steatohepatitis".  Steato means fatty and hepatitis means inflamation (inflammation).  If your liver enzymes are elevated then you have inflamation (inflammation).  The higher the numbers the more inflamation (inflammation) you have.  Since your liver enzymes are only slightly elevated then you most probably have steatohepatitis.  It is a mild disease and the doctors are not usually worried about it too much.  Are you overweight?  Is your cholesterol too high?  Does diabetes run in your family?  If your answers are yes then you should lose weight is a sensible way.  Losing weight too fast can damage the liver.  
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My diabetic husband (59yr. old, 4 shots a day) had routine preop blood tests done today, followed up with visit to GP because he was feeling fluie and had not been getting over a chest cold that he has had for about two months.  Doc notes that his liver function numbers are about three to four times higher than they were 9 months ago.They are now talking fatty liver, hepatitus (hepatitis) etc.  I am scared to death.  

He was to have a rotocuff tear fixed but that is out for the moment.

Knowing being diabetic can cause liver problems, I would like to know is there treatments to make the liver disease livable?

All we were told is not to take any otc drugs and go see a liver specialist.  Is there anything that can be done until he sees one?

Thank you in advance for any help you can give me
Pam
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