Questions about fatty liver

[momto2]

Hello! I would like some clarification about Fatty Liver disease. Some past hx: 41y female. non-smoker/drinker, 175lbs, 5'9. I have had a short term history (2 months) of nausea, right side discomfort, belching and "lump in throat" sensation. I recently had a total abdominal US. Found some misc things such as renal cysts, possible stone in left kidney, right ovarian cyst. The thing I don't understand is it also listed that I have "fatty infiltration of the liver". The report said the liver is normal in size and shape. There is mild coarsening to its echogenicity.There was no other measurements given. Gallbladder is OK. 1)What do those terms mean and how concerned should I be? 2)Do I have a mild case of this? I had a complete physical with labwork about 31/2 months ago. My triglycerides were over 300 and my cholesterol was 206. Otherwise everything else was WNL.ALT-21, Alk Phos-73.3)Do I need another set of labwork? I watched my diet for 2 weeks and got my TRI to 131 and my Chol-161. I know I need to continue to watch what I eat. 4)Is this a condition that comes on suddenly or over a long period of time? 5)Can it be resolved permanently with diet or is that a temporary correction? I have read through the forums and sometimes see that a biopsy needs to be done and it can be serious and other times it is considered benign and does not progress. 6)Will this condition progressively worsen? My gastro Dr. does not seem concerned.7)Is this condition common?Please fill me in about this because I am very worried. I am scheduled for a Hida scan and an upper GI.

[Kevin Pho, MD]

To answer your questions:
1) Fatty liver can be caused by alcohol, or associated with obesity and elevated triglycerides.  If the liver enzymes are negative, this is less concerning.

2) An ALT of 21 suggests a mild case.

3) Serial monitoring of the liver enzymes is recommended.

4) It is normally a condition that comes on gradually.

5) If not associated with alcohol, it can be treated with weight loss and diet modification.

6) Yes, if it is not appropriate treated, the condition can worsen.

7) This is not an uncommon condition.  I agree with the HIDA scan and upper GI series as additional tests.

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_

[Kalio1]

Do you recall what your liver enzyme readings were? Your AST/ALT numbers? Those numbers give an indication of the inflammation of your liver. You seem to be having some symptoms, the "lump in throat" symptom is particularly troubling, I'd follow up on that and have them check your throat to make sure they don't see any signs of varices. Have you seen a Heptologist? I'd recommend it, they specialize in the liver and it ould behoove you to see one to better access your situation. In the early stages fatty liver is benign however it is a progressive condition and needs to be taken very seriously and steps need to be taken so that you can remove that fat from your liver through top nutrition and exercise. Here is a link from the Mayo clinic that has a lot of info, maybe that will be helpful. You can start right away and follow a liver friendly diet and maintain a daily exercise plan.

http://www.mayoclinic.com/health/nonalcoholic-fatty-liver-disease/DS00577

[momto2]

My last labwork was in July. AST 22 (range 10-42). ALT 21 (10-60 range). To me that looks normal. However the Dr. just said ALT 21 indicates a mild case. I don't really understand that. I haven't talked to anyone who seems paticularly concerned. I don't know if there is a hepatotologist in this area or not. I just want to get back to my life and quit worrying about this.

[gobipuba]

It is possible that your lump in the throat could be caused by reflux.  It is called globus sensation. You mentioned belching a lot. If the acid  goes up your esopahgus into your throat it could irritate these delicate tissues, and make it feel like you have a lump in your throat.  Does it go away when you drink water or eat food?  Is is worse when you just try to swallow without food?  I would have it looked at by an ent or have a scope down your throat done by a Gi specialist, instead of the upper GI series.  They could rule out the bad stuff dealing with the lump sensation, and reassure you on this issue.  Treatment for this is acid suppression through PPis and other acid reducers.  It also is made worse by anxiety.  I hated it when I had it, but it eventually goes away.

[momto2]

Thanks for your reassurance! I hope it is as simple as reflux that prevacid or something would help. I have recently started on prevacid and it does seem to help. Depending what they find on Upper GI the Dr. said they might follow it with an EGD and pancreatic CT.

[redneck29]

A related discussion, liver problems - unexplained was started.