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Gastroenterology (Expert Forum)
Should I get a second opinion?
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.
Should I get a second opinion?
by gmn, Jan 10, 2007 12:00AM
I am a 43 yr old male, generally in good health but have been regular drinker for 20+ yrs. I recently quit and haven't had any withdrawal or other symptoms but now am worried I have damaged my liver. I went to my Primary Care Dr for a complete work-up (LFTs, physical exam of liver and abdomin (abdomen), check for other physical signs of liver disease, etc..) and review previous LFTs. All of the previous LFTs have been in the normal/high normal ranges and some of these recent tests, while trending up by a few points, were normal/normal elevated( i.e. AST 38, ALT 49, Tbilli 1.1) He said I have no outward signs, and upon physical/clinical exam of my liver, he said everything felt fine/consistent (i.e. no inflammation, hardness, or otherwise). Since my labs were normal, he didn't see the need to have further testing done. Could he have actually felt any abnormalities with the liver during the physical/clinical exam? Should I push him to do further testing or refer me to a gastro DR? Not sure what to do here as he was pretty confident I was okay...
Doctor's Answer
by Kevin Pho, MD, Jan 11, 2007 12:00AM
, Jan 11, 2007 12:00AM
The physical exam is not very sensitive in picking up liver disease.
The normal liver enzymes are encouraging. If further workup is warranted, the next step would be a liver ultrasound. Given the normal LFTs, this test is not normally indicated.
You may want to discuss this option 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_
The normal liver enzymes are encouraging. If further workup is warranted, the next step would be a liver ultrasound. Given the normal LFTs, this test is not normally indicated.
You may want to discuss this option 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_
Member Comments (1)
by cantlivenotknowing, Jan 10, 2007 12:00AM
Check the enzymes every month for the next six month's to see if they normalize with no drinking. If so, you have very little damage if any. However, you are in the age range when long term hard drinking can catch up with you pretty quickly and elevated enzymes are the 1st step in the direction of much more serious problems. Eat healthy, don't drink and check enzymes for the next six month's. I'd bet your o.k., but treat your body right going forward. If the enzyme levels stay up, follow up with a gastroenterologist would be a good next step.
