Trying to Figure What Could Be the Cause of My Symptons

[hcin200111]

For the past 2 weeks I have been having pain in my upper right abdomen under ribs. I have been constipated and have had gas. The pain in my abdomen is dull to moderate. I work on a computer and bending over too much the area is a little tender. The pain also sometimes goes to my lower right side of my back and hurts there too. The pain goes down to my lower right abdomen also. This all doesnt happen at once and then sometimes it does. Also pain in my shoulder. I also have tested positive for anti-Hep C antibodies. Not sure if I am infected with the virus or not, I need to do more tests. But I had a transfusion in 1978. I went to donate blood and they told me that I had Hep C..."(....I am SOOO scared. I guess I contracted it in 1978 when I had a blood transfusion which was needed from a miscarriage I had. I think the test only shows that I tested positive for antibodies; meaning I have been exposed at one time. Now from what I'm reading I need to have another blood test to test if I still have active virus or or if it is cleared up (which is apparently rare). What is the next blood test or tests called that I should have?
Also, for all these years I have felt fine. So not sure if I'm having or have had symptons from that or not. I have read some of the symptons and I recently have had some.,(hot flashes, burning pain and dull ache in right side of abdomen, constipation, pain in my right lower back) but they are similar to symptons that go with perimenopause which I'm going thru now. Its been 26 years since I supposedly caught Hep C. Would I have some sort of more major symptons than I have now? I've read where it takes up to 20 yrs or so before you feel anything. Does that mean if I do have the virus still after all these years, it has been damaging my liver all this time? Or does it start damaging it after 20 or 30 yrs? Could I have cirrosis and not know it or would I have symptons by now for cirrosis? I have so many questions...I'm really scared....I also have two children that I had after 1978. Should they be tested? Could they have Hep C too?? Also I've been living w/my fiance for over 2 yrs...can he get it too? Please if anyone can give me some answers, please do...I would greatly appreciate any support I can get. Thank You So Much!!! God Bless :)

[Kevin Pho, MD]

Bibliography:
Pratt et al.  Alkaline phosphatase and other enzymatic measures of cholestasis.  UptoDate, 2004.

[surgeon]

cirrhosis doesn't usually cause intermittant pain such as you describe. Gallbladder disease could. Rather than decide in advance what blood tests you might need, you ought to see your doctor, and get started on an evaluation, which likely would include screening blood tests, and ultrasound of your liver, gallbladder, and other internal organs.

[pepsi one]

hello i have a problem with having a lot of gas all the time this is not normal myhusband doesn't have this problem and now my little one has the same problem and we are always complaning about our tummys hurting and i wont ask my doctor about this and i have had this all my life i'm 37 and it doesn't matter what i eat or not we both have a lot and sometimes its worst then other days do have an answer to this. why

[J B. (John the Baptist)]

Hello, I would advice you to consult a doctor,secondly it would be advisable to evaluate your liver profile.i.e- liver enzyme.
and liver biopsy,besides the most important is that your doctor
will first of all ask you to go for a test to detect the genotype
of the virus if at all it is available.

[kevinmd]

Sorry, that was a typo in the answer above.  The rest of it will be coming.

Thanks,
Kevin, M.D.

[kevinmd]

I agree with surgeon's comments below that a more thorough evaluation, including ultrasound and liver function tests are needed.  To answer your questions:
1) The next tests to consider would be hepatitis C antibodies, and if positive, a quantitative hepatitis C viral titer (which would identify how much of the virus is present).  

2) The symptoms would depend on how far the liver disease has progressed.  Many patients with hepatitis C are asymtpommatic.  The most frequent complaint is fatigue; other less common manifestations include nausea, anorexia, myalgia, arthralgia, weakness, and weight loss.  If you're having more pain-associated symptoms, you may want to consider an ultrasound to evaluate for any gallbladder symptoms.

3) Regarding cirrhosis, the ultrasound would help in diagnosing that.  If the hepatitic C viral titer shows evidence of virus, a liver biopsy can be considered to confirm whether cirrhosis is present or not.  

4) Regarding how hepatitis C is transmitted - the virus is spread by contact with blood. Thus, you should avoid activities that risk exposing another person's blood to your blood. Examples include sharing a toothbrush, nail clippers, razors, and needles.  It can also be uncommonly transmitted sexually.

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.

Thanks,
Kevin, M.D.