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Liver Transplant (Expert Forum)
Ascites and jaundice - without hepatitis/cirrhosis?
Answered by
Thomas D Schiano, MD - Internal Medicine, Gastroenterology, Liver Transplantation, Hepatology
The Mount Sinai Medical Center
New York - NY
Questions posted in the Liver Transplant . Forum are answered by medical professionals from The Mount Sinai Medical Center.
Ascites and jaundice - without hepatitis/cirrhosis?
by mhMedHelp, Oct 19, 2008 10:27AM
My husband is an alcoholic, drinking heavily for the last 5-6 years. He does not think he has a problem (as he does not drink 'hard alcohol', only red wine) but his dialy consumption is between 320 and 520 ml (260 to 420 grams) of pure alcohol.
Last year he put on about 10 pounds in 4 days which meant that he agreed to see a doctor who diagnosed ascites. He also had a jaundice and his blood tests were v. high (doctor said he was the most sick person she saw that week), at that point his liver and spleen were both enlarged. He refused to be admitted and stopped drinking for a while, taking milk thistle, vitamins and diuretics, the jaundice and ascites went away and he got generally better. He is now drinking again (in fact he gave up 3 times since that time but it only gets worse). His eyes sometimes get a bit yellow but generally he seems to be better than last year. He refused any more tests last year except ultrasound which he says showed that he had fatty liver and portal hypertension. He will not discuss the problem and I cannot discuss the situation with his doctor because of the patient confidentiality.
Most of the references that I found state that the ascites and jaundice in alcoholics are signs of hepatitis/cirrhosis. My husband says that the radiologist said after the ultrasound that there was no scarring, 'just' fatty liver. Is it possible that at this stage he really 'only' has fatty liver. Would the radiologist be able to say or is biopsy required? What is the likelihood of having had ascites, jaundice and portal hypertension and not having hepatitis/cirrhosis? Thank you.
Last year he put on about 10 pounds in 4 days which meant that he agreed to see a doctor who diagnosed ascites. He also had a jaundice and his blood tests were v. high (doctor said he was the most sick person she saw that week), at that point his liver and spleen were both enlarged. He refused to be admitted and stopped drinking for a while, taking milk thistle, vitamins and diuretics, the jaundice and ascites went away and he got generally better. He is now drinking again (in fact he gave up 3 times since that time but it only gets worse). His eyes sometimes get a bit yellow but generally he seems to be better than last year. He refused any more tests last year except ultrasound which he says showed that he had fatty liver and portal hypertension. He will not discuss the problem and I cannot discuss the situation with his doctor because of the patient confidentiality.
Most of the references that I found state that the ascites and jaundice in alcoholics are signs of hepatitis/cirrhosis. My husband says that the radiologist said after the ultrasound that there was no scarring, 'just' fatty liver. Is it possible that at this stage he really 'only' has fatty liver. Would the radiologist be able to say or is biopsy required? What is the likelihood of having had ascites, jaundice and portal hypertension and not having hepatitis/cirrhosis? Thank you.
Doctor's Answer
by Thomas D Schiano, MD, Oct 21, 2008 07:06AM
, Oct 21, 2008 07:06AM
although it is possible he does not have cirrhosis and only alcoholic hepatitis this in itself is a life threatening condition as are all the other complications of portal hypertension. Although many of these things can be reversible eventually people reach the point of no return. He needs to enter a structured relapse prevention program ASAP if at all possible.
Member Comments (2)
by mhMedHelp, Oct 21, 2008 07:49AM
To: Dr Schiano
Thank you.
