Possible Cirrhosis?

Hello,

I have been scared for about 6 months now that I have some liver damage, possible cirrhosis. I'm a 24 year old male and I drank severely heavy for about 3 years, and just recently quit in January of 2009. I have a pretty intense tightness kindof pulling pain in my epigastric area when I eat a moderate amount, and this has been going on for quite some time. I feel nauseas on occasion. Sometimes I feel pains in my liver area as well. As the day progresses, I notice a mild to moderate amount of swelling in both of my ancles, and I wake up in the morning with a little swelling beneath my eyes. It seems that I am always tired, and eventhough my doctors don't seem concerned, I believe I have palm redness as well. I have a few tiny pin head sized dots on my upper chest, and one on my forearm, and two on my abdomen. I have felt like my head is in the clouds pretty much constantly for about 3 years now. Just a really weird feeling, and I can't really even say I remember what it's like to feel normal. I also have the feeling of being shaky a lot, kindof like a very mild tremor, almost unnoticeable.

I have had several tests, but what I am most concerned about is the ast/alt ratio. I have 3 recordings of these enzymes and my first one was  ast-20, alt-27. The seocnd one was about a week later at ast-24, alt-22, and the third one was about a month after that at ast-19, alt-19. From reading online I see that it says if your ratio is >=1 that is an almost SURE sign of liver cirrhosis. My question is, eventhough my levels are in the perfectly normal range, does it matter that the ratio is above or equal to one or is that only significant in higher enzyme levels? I am sooo scared about my health and I really need some guidance. I have had a full abdominal ultrasound and the doctors say that my liver has a normal appearance with a normal contour, and my spleen has a normal appearance as well. If I have progressed with all of these symptoms, shouldn't something have come up on the ultrasound considering I have abdominal fullness and whatnot. If this isn't cirrhosis or liver related, what in the world could it be. I was under the impression that the ultrasound is the best diagnostic test for cirrhosis outside of a biopsy. Thank you for viewing this and please, I'll take all the advice I can get. Also, if there is someone out there that is experienced in reading ultrasound images, I would be glad to let them have a look for themselves to see if anything was possibly missed.

[mikesimon]

I don't believe that when your liver enzymes are within normal range the ratio means anything. I know too many people whose AST is higher than their ALT. I think the ratio, even in elevated numbers, is not as absolute as some articles suggest.
I had labs drawn last month: AST 17   ALT 10. I know I'm not cirrhotic.
If you were cirrhotic you would likely have shown some abnormality on ultrasound. And often the spleen is enlarged in a cirrhotic patient. You might also expect to see a low platelet count.
When I hear these types of complaints I think of gallbladder issues but that's just a guess.
If I were you I would stop drinking or cut down significantly.
This board occasionally has a MD drop in but you might have a better chance of getting an expert answer at the "Liver Transplant Help". Though your question isn't  strictly transplant related he might answer you and put your mind at rest.
Here is the link:
http://www.medhelp.org/forums/Liver-Transplant/show/274

Good luck,
Mike

[aMom21]

A CT and MRI are much more sensitive to cirrhosis than ultrsound.  I was told that advanced liver disease would almost 100% show up on these test.  I am sure there are exceptions.  You are young and it is very doubtful that you have developed cirrhosis so quickly although I can't say for sure.

[mikesimon]

Liver biopsy is the best diagnostic test for liver disease but Storeon had an ultrasound.
He didn't undergo CT, MRI or liver biopsy. You have to work with what you have and, in my opinion, from what he's said he isn't cirrhotic.