Recent cirrhosis diagnosis

[Excursionist]

Hi all, I thought I might share my story in case it suggests comments to any of you.

Some years ago as a young adult I had a pretty significant alcohol history, to the point that a family doctor at the time said that I appeared "pre-cirrhotic" (skin blotches) and needed to stop.  I did stop within a year or two, and have had no further alcohol use for the past 22 years.  I'm now in my mid-50s.

For a while after I stopped, my doctors said my liver enzymes were a little high, but they became normal.  Then, a few years later, I started getting pains on and off on the right side just below where my liver is that were exacerbated by various medications.  I had several CT scans and other imaging over several years which supposedly showed that my liver appeared to be fine -- it was normal size, etc -- and my blood tests by now were in the normal range.  The doctors also checked out my gallbladder and I had a colonoscopy, all of which failed to reveal any cause of the on and off pain.

Recently, one of my doctors thought the liver needed a closer look, and referred me to a hepatologist.  (I'd been asking several family doctors for several years for such a referral, but they had consistently refused on the basis that there was nothing to indicate that I had a liver problem. As for my alcohol history, they uniformly said, "The liver is very resistant, and it can recover even if you abuse it.")

In December I had a liver biopsy and a new CT scan, which the hepatologist said was optimized to look for evidence of liver scarring.  Interestingly, the liver biopsy came up negative for cirrhosis, but positive for some degree of fatty liver.  The CT scan, on the other hand, came up positive for cirrhosis.

The hepatologist describes my case as "very early" cirrhosis -- "I just made the diagnosis because the CT scan showed irregular contour," he said.  He also described all my liver blood tests as revealing it as being "functioning perfectly."  But the scarring is apparently significant enough that I have to follow the rules that he lays down for any cirrhosis patient.  No more sushi, no NSAIDs (but baby aspirin and low-dose Tylenol is okay), blood tests every three months and ultrasound every six months to monitor for liver cancer.

When I asked him the odds of getting liver cancer, the answer was interesting.  He said it was 1%-3% for every year that I have cirrhosis.  "Given that the damage would have been done 22+ years ago, does that mean my odds now are 22%-66%?" I asked.  "Well, we don't know that you've had cirrhosis for all that time," he replied.  "You may have only had it for a couple of years."

Although this seemed superficially encouraging, after I thought about it it seemed more problematic.  I was assuming that with the cessation of alcohol (and avoidance of other problematic medications) that not much further damage would take place.  But his answer suggested that, even if I follow the best diet and exercise lifestyle, it could continue to progress?

When I asked about supplements such as milk thistle, he said "the numbers just aren't there" to establish a benefit, but he said it wouldn't hurt to take it -- "the only damage will be to your pocketbook."

So that's my story.  If anyone has any comments about it, I'd be very interested.  Also if you have any other suggestions on good things to do to stay as healthy as possible, I'd be very interested.  My health is otherwise pretty good -- weight at upper end of normal range for body mass index, walk two miles a day, resistance training twice a week, have eaten low-fat diet no mammals for years, recently went low-sodium.  On the basis of this and also athersclerosis that the CT scan turned up, I've also given up refined sugars, will be concentrating on low-glycemic foods and will probably take my diet further in a vegetarian direction.

[Excursionist]

Congratulations on stopping drinking. It's possible to have drinking problems just on beer -- that's pretty much all I drank.

Since I made the post above, more than a year has gone by and I've seen my liver doctor a couple of times.  He has clarified that in fact he wouldn't expect the state of my liver to be worsening now, but rather improving.  I do get an ultrasound and blood tests every six months to keep an eye out for liver cancer.  The blood tests all come back in the normal range.  The only thing that was difficult was giving up sushi!  I have to say, though, that several other doctors are skeptical of the cirrhosis diagnosis -- they say that since my biopsy was negative they're doubtful. Right now I'm mostly focusing on my diet and exercise in terms of keeping my cholesterol down and trying to lower my triglycerides.

Good luck with your doctor's visit.  If you have any difficulty staying off drinking, support groups can be very helpful, especially for the first couple of years.

[achuck]

thankyou for the great article. It was very informative.  I am 67 and have been drinking most of my life.  Mostly light beer but a lot of it.  I drank about one to one and a half cases a week  especially for the last 4 years since I retired.  I thought I was bullet proof.  I stopped drinking 2 days ago.  I feel i have a liver problem and have made an apointment for a physical this friday.  My weight has dropped about 8 lbs in the last mo and I have had a strange smell in my breath  that my wife has been telling me about.  I have had some very slight feeling in my right side mostly around the back.  I am very worried and wonder what the future will bring.  I had a physical about a year ago but it sounds like that could have missed something.  I know my breath has changed so something has been going on inside of me.  love to hear from you