Liver and Stomach Issues

[djfarmboy]

I am a 46 yr old male.  About 6 years ago I started to develop internal pains (mid section) that could not be identified.  Through persistent requests I was finally diagnosed with cardiomyopathy.  Cardiologist suggested a viral infection.  Pains persisted and was told it was not cardiac related.  As pains persisted, I was diagnosed,via abdominal ultrasound, with gall stones and my gall bladder was removed.  Following removal, I had liver type pains and diareaha and finally requested a gastro specialist.  18 months ago I had a colonoscopy and upper GI barium swollow with normal results.  I was also checked for malabsorbtion with normal results.  I was advised by my gastro dr. that I was in the 5% that may continue to have some issues.

Over the last several years my ALT has been up and down between normal and mild elevations.  Last November my ALT was the highest at 99.  I was asked to stop alcohol and retest.  Before the retest I presented with liver type pains and left flank pain.  In December I had an ultrasound that showed very slight increased echotecnicity which could be mild difuse fatty liver.  I was asked to drop weight and I have cut out most alcohol.  I still have a couple drinks every two weeks.

3 weeks after the 99 ALT I retested at 68 and in March is was back down to 23.  I have lost 35 pounds with 15 to go.

In the last few weeks I have developed what I think is neuropathy in my hands and feet.  They will tingle as the day progresses following from waking feeling normal.  With exception to this I feel better than I have in 20 years.  I don't recall ever being tested for hepatitis.  I will be seeing my GP in three weeks and I have the following questions to help prepare me for that visit.  

1.  Does the ALT return to normal (23) help eliminate that my issues are due to any type of chronic hepatitis?
2.  Should I request a hepatitis test?
3.  Could neuropathy be related to any of my liver/gastro issues?
4.  I have been in a manomogous hetro relationship for nearly 10 years.  I know there are many, but sex is one way of transmissions.  Could hep be present and no show signs for so many years?
5.  Anything other information you might suggest?

Thanks for your service.

[Kevin Pho, MD]

To answer your questions:
1) A normalizing ALT would make chronic hepatitis less likely.

2) If the ALT had been elevated previously, it would not be unreasonable to obtain a hepatitis test.  I agree with the abdominal ultrasound that was ordered.

3) Possibly.  There are some liver and GI diseases that may manifest with neurological symptoms.  Obtaining nerve conduction studies would help better define any nerve damage.  I would also consider a referral to a neurologist.

4) A chronic hepatitis B carrier state can lead to minimal symptoms.  Blood tests can help with this possibility.

5) I agree with the testing that has been done.  An upper endoscopy, gastric emptying scan, and 24-hr pH study are all more specialized tests that can help with the symptoms.

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_

[nicola999]

hi there
my husband has been having liver functions tests for the last 6 months, his first results his sgpt was 205 and sgot 100, after which he had an ultrasound scan, which showed as clear.
He was then tested for hep a b and c which were clear also, and then monthly liver functions tests sgpt 94 and sgot 51, then sgpt 111 amd sgot 55. then sgpt 77 and sgot 57 then sgpt 88 and sgot 59. The first test was Nov 15, the last test April 17, this year.
The doctor has now said for my husband to go for a liver biopsy to find out what he has. We know that this test involves some risks with bleeding etc. do you feel this is necessary and what are your comments?  

[Kalio1]

I'd have the doctor check you for Hep b and c just to be safe.

[redsoxman84]

Hi all i was wondering if you could help me out.  I am in my low 20s and in august i had hig liver enzymes and i had negat hep. test results and a full normal abdomen ultrasound.  Lately i can feel when i push in under my right rib cage all the away around a thumping feeling as if i feel like bubbles and i can feel it inside.  It only is there really when i am sitting and it only hurts because i poke at it a lot cuz im paranoid.  Anyone know what this could be.  I am overweight as well so people tell me its fat pockets and other stuff.  Help please?