Digestive Disorders / Gastroenterology Expert Forum
Fatty Liver
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Fatty Liver

Hi, I saw my Gastro Doctor About My Mild fatty liver he told me that I did not need to have any other test to find out what was causing fatty infiltration. because my ALT.& AST. was well into normal range. My ALP. was 127 My Lab Normals Were Between 25-150 My question is the research that I have conducted says that a Liver Biopsy Should be done. I do not normally Like to do this but, is it necessary for me to find another GI Doctor,I do not want to just ignore this problem. Iam having alot of anxiety over this situation.

Thank you,  Foundry.
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Typically a liver biopsy isn't indicated if the ALT is below 3x the upper limit of normal.  I would assume that initial tests have been performed already, including an abdominal ultrasound.  Also, a liver biopsy would simply show fatty liver - not necessarily the cause.  

I would abstain from alcohol and continue to serially monitor the liver.  If alcohol is not the cause, weight loss and exercise can also help.  

These options can be discussed with your personal physician.

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_
6 Comments
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Avatar_m_tn
I think you are smart to want further evaluation. I agree with you, you need a second opinion. I'd see a heptologist ( liver specialist) You are right that a biopsy is the "gold standard" of determining liver status but you don't necessarily need one. Liver enzyme readings are not an exact measure of what is going on in your liver. Have you been tested for viral hepatitis? I would test for it to make sure that is not present. Are you having any symptoms? Fatty liver can be "cured" through a good healthy diet and good excercise. I'd get another opinion and more advice than your current doctor is offering.
It is always a good idea, with any liver problem to avoid all alcohol. Fatty foods and lack of excercise or being overweight cause fatty liver but so does alchol.
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Avatar_n_tn
Hi, Just thought I would Comment, to say that 3yrs.ago I had alcohol induced pancreatitis After i was cleared of pancreatitis , Through a CT Scan he said i had fatty deposits on my liver, it was a CT Scan 8/15/2006 That Showed Mild diffuse fatty infiltration without focal lesions or duct dilation. I have also talked with the liver foundation and they said viral hepatitis doesnt cause fatty liver.

Thank You Foundry
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Avatar_n_tn
HI,I JUST FOUND THIS SITE AND JUST WANTED TO LEAVE MY EXPERIENCE IN THE LAST 7 MONTHS. I HAVE AN EXTREMELY RARE SYNDROME CALLED WAARDENBURG SYNDROME. I WAS UNAWARE MY FAMILY CARRIED THIS GENE UNTIL MY DAUGHTER WAS BORN HEARING AND VISION IMPAIRED AS WELL AS TWO DIFFERENT COLOR EYES. I HAD MY GALLBLADDER(EMERGENCY) REMOVED AT 22--I HAD EXTREME CASE OF CHOLESTROL STONES.I AM NOW 37 130LBS AND WAS HOSPITALIZED WITH EXTREME PANCREATITUS (pancreatitis) AND IRRITATED STOMACH.WHEN I ENTERED THE EMERGENCY WITH SEVERE STOMACH PAIN,SIDE PAIN,NAUSEA ETC. I HAD ALMOST 3,000 TRYGLCERIDE READING.I WAS STARVED FOR 6 DAYS AND PUT ON HEAVY DOSES OF DEMORAL AND PHENOGHAN FOR NAUSEA. SEVEN MONTHS LATER I HAD A NEW CT SCAN AND WAS FOUND TO HAVE A SPOT ON MY LIVER.MY PANCREAS HAS WENT DOWN TO NORMAL SIZE(I AM ON CRESTOR,TRICOR AND OMACOR) TO KNOCK MY TRI'S DOWN. THEY ARE NOW DOWN TO 200.WHICH IS REALLY GOOD CONSIDERATING WHAT THEY WERE. HOWEVER,I AM NOW CONCERNED ABOUT THE IDEA OF FATTY LIVER DISEASE. MY GASTRO DOCTOR SAYS ITS VERY COMMON TO HAVE THIS DISORDER WITH LIFETIME PROBLEM WITH FAT IN THE BLOOD. I AM NOW SCHEDULED TO GET AN MRI OF THE LIVER AND LOTS OF BLOOD WORK FOR PROTEIN LEVELS IN THE LIVER ETC. I HAVE BEEN TESTED FOR HEPATITUS (hepatitis) AND IT IS NEGATIVE. I JUST WONDERED IF ANYONE OUT THERE IS HAVING A SIMILIAR PROBLEM OR IF THE DOCTOR ON HERE COULD GIVE ME ANY ADVICE.MY DOCTOR SEEMS TO DISMISS THE IDEA I HAVE CANCER.HE IS ALMOST POSSITIVE HE SAID ITS JUST A FATTY SPOT.I AM STILL WORRIED AND UNRESTED ABOUT IT. BY THE WAY I AM NOT A ALCHOHOL DRINKER AT ALL.I WOULD APPRECIATE IT IF I COULD GET SOME SOUND ADVICE OR COMMENTS.HAVE A GREAT WEEK!
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Avatar_n_tn
Hi Just Thought I would comment on your situation. As You may Already know High Levels of cholesterol is definantly a good cause for the pancreatitis. As For the Spot on your liver I would not let the thought of cancer start to gET INTO YOUR HEAD OR YOU WILL WORRY YOURSELF SICK. iT cOULD BE A SPOT OF FAT ON YOUR LIVER. As for fatty liver there are many causes for this.There is a condition called simple fatty liver that does not cause any permanent damage. Although It Can mildly eleate liver function tests. There is also A Condition Called non-Alcoholic Fatty Liver That Can cause scarring To The Liver. But you can also Do Something about this by watching your real fatty foods. And getting exercise. Diabetes can cause fatty liver Also A Test That Could Be Considered IS a HBA1C test This Test Detects how well your body has been Excepting Insulin Or If You may be insulin resistant. Fatty liver itself Is A benign Condition That Is Reversable Or Can be controlled That it may not progress. The american Liver Foundation Is Very Helpful The Number Is 1-800-GO-LIVER. After Talking With Them You Should Feel Alot Better. Try Not to Worry I Am Sure You will Be Fine. Also Watching Your real Fatty Foods You could Really see A difference In Your Cholesterol Levels.I Also Forgot to Mention How Are Your Liver Function Tests This Would Be Your AST/ALT/ALP etc. keep your chin up and you will be fine. Anxiety Meds May Be Helpful if You need them.                    Foundry:
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Avatar_n_tn
HI,THANKS FOR COMMENTING. I WAS TESTED FOR HEPATITUS (hepatitis) AND IT CAME BACK NEGATIVE. MY LIVER FUNCTION WAS ELEVATED SLIGHTLY(50) WHICH NORMAL IS 16-40.. BUT I AM ON 3 DIFFERENT STATINS SO I FIGURE THAT MAY HAVE SOMETHING TO DO WITH IT. MY GASTRO DOCTOR DID SAY HE DOUBTS ITS ANYTHING SERIOUS HE JUST WANTS TO RUN TESTS TO MAKE SURE. I WILL CONTACT THE LIVER FOUNDATION AND THANKS FOR THE NUMBER.MY BLOOD PRESSURE IS PERFECT AND MY SUGAR HAS BEEN COMING BACK REALLY GOOD. I HAD THE PANCREATITUS (pancreatitis) IN FEB.SO ITS BEEN A WHILE I ALSO FIGURE IF I HAD CANCER IT WOULD HAVE PROGRESSED AND THINGS WOULD HAVE STARTED ACTING UP BY NOW.MY NUMBERS HAVE ALWAYS BEEN GOOD ACCEPT TRI'S AND CHOLESTROL.IF YOU CAN THINK OF ANYTHING THAT MAY BE HELPFUL TO ME PLEASE LET ME KNOW--HAVE A WONDERFUL WEEKEND.
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Avatar_n_tn
Hi, My brother-in-law had emergency surgery due to severe abdominal pain. Once in they found that 4 foot of the small intestine and 2 foot of the colon were damaged due to blood clots they say it was caused by a very diseased liver. They took biopsies and labs but not all the tests are back. what has come back is pointing to a fatty liver. He does not drink at all and yes he is alittle over weight but not obesite at all. We were wondering if the death of the small intestine and colon were a result of the liver or it the liver would be damaged by the intestine and colon dying. also can this be reversed or treated  Thanks catipillar
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Avatar_n_tn
I had gastric bypass over a year ago and in the following mos I had my gallbladder removed due to gallstones.  Ever since I still have pain in my upper abdomen.  I had two ultrasounds and the doctors found two groups of blood vessels that showed on test but they said it was nothing and not to worry.  My pain continued so I saw a dr of internal medicine.  She ordered a CT scan and I just got word that there is an area of the liver that needs to be further examined.  I have to go for a MRI.  I'm so scared.  I have a history of alcoholism and go periods without drinking off and on. All my blood tests have come back normal except my AST was 46 (normal 5-40).  I'm so worry that I don't know if I will be able to sleep.  I hope it's not serious.  I have no other symptoms what-so-ever.  Can anyone relate or offer some thoughts?
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Avatar_f_tn
A related discussion, Irritating pain on right side under my rib was started.
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Avatar_m_tn
A related discussion, medicine of fatty change in the liver was started.
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