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Gastroenterology (Expert Forum)
Enlarged Liver in Young Woman
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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.
Enlarged Liver in Young Woman
by truman, May 29, 2004 12:00AM
Hi-
I have posted here a couple of times before, and I just have to let you know how much I appreciate this service. I won't go into the long story, but an answer you gave me several months ago has literally changed my daughter's life! So thank you.
Unfortunately, I have another question for you!
I am 30 years old with two healthy young children. I do not smoke or drink. In the last few months, I have had shortness of breath and chest pain, located directly behind my sternum and throughout the bottom right side of my ribcage. I have lost 25 pounds despite efforts not to...I am 5'5" and under 100 pounds now.
Two doctor's visits have yielded the following information...my ALT and AST are slightly elevated (both around 60 with around 40 being the maximum normal on their scale); my liver is enlarged on physical exam and subsequent CT scan; my lungs and heart are functioning normally on CT scan with contrast; thyroid function tests are pending.
I was caught off guard by the prospect that my liver was of any possible concern, and so didn't ask many questions at the appointments. I'm hoping you can answer some questions and point me in the right direction...
1. Is there any disorder involving the liver that can cause the symptoms of rapid weight loss, shortness of breath, and right-sided and central chest pain?
2. The doctor did not seem too worried by the enlarged liver. I actually have not even scheduled a follow up. Is an enlarged liver always a sign of disease or can it be totally benign? Is it likely that the other symptoms are unrelated to my liver?
3. Can you suggest the next step? Should I call my doctor with questions, or should I schedule an appointment instead? Is there any further testing I should request?
Thank you so much for your time. I really appreciate it.
-Truman
I have posted here a couple of times before, and I just have to let you know how much I appreciate this service. I won't go into the long story, but an answer you gave me several months ago has literally changed my daughter's life! So thank you.
Unfortunately, I have another question for you!
I am 30 years old with two healthy young children. I do not smoke or drink. In the last few months, I have had shortness of breath and chest pain, located directly behind my sternum and throughout the bottom right side of my ribcage. I have lost 25 pounds despite efforts not to...I am 5'5" and under 100 pounds now.
Two doctor's visits have yielded the following information...my ALT and AST are slightly elevated (both around 60 with around 40 being the maximum normal on their scale); my liver is enlarged on physical exam and subsequent CT scan; my lungs and heart are functioning normally on CT scan with contrast; thyroid function tests are pending.
I was caught off guard by the prospect that my liver was of any possible concern, and so didn't ask many questions at the appointments. I'm hoping you can answer some questions and point me in the right direction...
1. Is there any disorder involving the liver that can cause the symptoms of rapid weight loss, shortness of breath, and right-sided and central chest pain?
2. The doctor did not seem too worried by the enlarged liver. I actually have not even scheduled a follow up. Is an enlarged liver always a sign of disease or can it be totally benign? Is it likely that the other symptoms are unrelated to my liver?
3. Can you suggest the next step? Should I call my doctor with questions, or should I schedule an appointment instead? Is there any further testing I should request?
Thank you so much for your time. I really appreciate it.
-Truman
Doctor's Answer
by Kevin Pho, MD, May 30, 2004 12:00AM
, May 30, 2004 12:00AM
I'm glad that you have found the prior information useful.
To answer your questions:
1) Rapid weight loss increases the risk of gallstone formation - so that can be considered, likely via an ultrasound. With chest pain, you want to ensure that the heart isn't the cause. A stress test would be the first step to evaluate this.
2) An enlarged liver can be due to hepatitis - any cause of liver inflammation. In addition to the liver ultrasound, I would suggest tests such as a hepatitis panel for further evaluation.
3) Ultrasound of the liver/gallbladder would be next to consider. The gallbladder and biliary system is not as well visualized during a CT scan. Stress tests to evaluate the cause of the chest pain should also be considered. If tests are negative, I would continue to periodically monitor the liver enzymes.
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.
Medical Weblog:
kevinmd_b
To answer your questions:
1) Rapid weight loss increases the risk of gallstone formation - so that can be considered, likely via an ultrasound. With chest pain, you want to ensure that the heart isn't the cause. A stress test would be the first step to evaluate this.
2) An enlarged liver can be due to hepatitis - any cause of liver inflammation. In addition to the liver ultrasound, I would suggest tests such as a hepatitis panel for further evaluation.
3) Ultrasound of the liver/gallbladder would be next to consider. The gallbladder and biliary system is not as well visualized during a CT scan. Stress tests to evaluate the cause of the chest pain should also be considered. If tests are negative, I would continue to periodically monitor the liver enzymes.
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.
Medical Weblog:
kevinmd_b
I will ask about the exercise stress test and an ultrasound at my next appointment.
Again, thanks for your reply!