Hepatocelluar disease likely caused by fatty liver

[Careful35]

Hello everyone. I have been having TONS of symptoms since March and have been going through testing for them still but I am concerned about my liver.

2 months ago I noticed I started getting these purplish looking raised spots on my skin with tiny veins going away from the center, (I later found out they are called spider nevu).. around the same time I noticed I had suddenly developed little what look like broken veins on my face, around my nose, mouth and chin. I found out later these are called Telangiectasia. I thought these things were strange but I have had so much other stuff going on that I sort of put it to the back of my mind as I already had a scheduled dermatologist appt for a cyst on my back and figured I would ask him about these things when I saw him but 16 days ago the palms of my hands suddenly turned red which I later found out was called Palmer erythema. At this point i started wondering what the heck is going on with my skin. So I called and had my dermatologist appt moved up.

I see him and discuss my cyst and start pointing out all these odd things and he points out some things to me like small brown spots, small white spots and some skin discoloration. I also told him that I thought it was strange that all my normal veins that I normally couldn't see before are showing through now. He advised me to go to my PCP for some blood work because these things are seen in liver disease.

I go and have blood work which I'm told came back olay but I insist there must be a reason all these things started popping up. I had a ct scan w/o contrast of my abdomen start of May for something else that said my liver was enlarged at 20cm but it appeared to be something called Riedels lobe verses true hepatomegaly. So after I saw the dermatologist I requested an ultrasound and had it done on last Tuesday. On Thursday morning I get a call from a nurse at my Drs office telling me my ultrasound was normal other then fatty liver which could be from diet or my weight but that if I was still having abdominal pain they could refer me to a gastro. I accepted the referral because in 2010 I had my gallbladder removed but still have the same sort of pain only not as severe.

I decided to go up to the Drs office to get a copy of the report so I have it for the gastro appt on August 16th. The report reads "diffuse increased echogenicity of the liver suggesting hepatocelluar disease likely caused by fatty liver"... I am not a Dr but to me it sounded like I have some sort of liver disease likely caused by fatty liver. I called the Drs office because now I want clarification.. unfortunately, I was just told the same thing and that I could discuss things with the gastro... I have been told that just fatty liver wouldn't cause all my skin symptoms..

I decided to go to thr hospital that did my ultrasound in 2010 where they found the gallstones to get a copy of the report and the report says I had gallstones and fatty liver... hmmmm no one ever told me this!!

I drank heavily in my 20s, I developed a drinking problem and I drank daily sometimes an entire 5th of brandy throughout the day and sometimes more. I stopped drinking about 7 or so years ago and have not had a drink since. I don't have a good diet, I am 5"1 and weigh 196 pounds. I take narcotic pain meds daily and have for several years now. I also was taking Advil daily and then Advil and Tylenol daily for about 6 months. I was taking 2 Tylenol every 4 or 6 hours for months. I didn't know Tylenol shouldn't be taken like that but when I found out a month ago I threw it away.
I have started a healthy diet and am starting to excersise in hopes that I can help my liver though part of me is worried i may have damage that can't be reversed. I have been told my liver enzymes are good. I had the comprehensive metabolic panel done and a lipase test but that is all. I have had high triglycerides since I was 10 years old and was just recently given meds to lower them this week. My good cholesterol is low but my bad cholesterol is good or within normal ranges.

I am worried about all these skin symptoms, I have am being worked up by a nuerologist for some neurological symptoms and I'm starting to now wonder if it's related. I read about the Palmer erythema and it says liver disease or can be also from a solid tumor growth which I found a lump on the left side of my ribs a few weeks before Easter while I the shower. It can be felt and is uncomfortable but I had a chest x ray and ct scan of my chest and abdomen but whatever this lump is it didn't show. I was set for a an ultrasound but then got a call saying it was cancelled because they can't ultrasound bone.. the lump isn't a bone but it's like my Dr won't listen to me about the lump since it didn't show up on the scans. When i read that the red palms could be caused by liver or tumor I got even more scared. I have the other skin symptoms for liver so it's probably likely they are from the liver too but either way I'm worried.

Is there anyone familiar with this here? What questions should I be asking? What can I do to help myself. I don't want to go googling as I know that will likely cause me to freak out. I'm sorry my post is so long but i did thank whoever took the time to read it.. I am a 35 year old female if by the way.

[flyinlynn]

Here is some info about NAFLD and NASH

Non-Alcoholic Fatty Liver Disease

Suggested Reading: Skinny Liver

IMPORTANCE
The liver is the second largest organ in your body and is located under your rib cage on the right side. It weighs about three pounds and is shaped like a football that is flat on one side.

The liver performs many jobs in your body. It processes what you eat and drink into energy and nutrients your body can use. The liver also removes harmful substances from your blood.

WHAT IS NAFLD?
Non-alcoholic fatty liver disease (NAFLD) is the build up of extra fat in liver cells that is not caused by alcohol. It is normal for the liver to contain some fat. However, if more than 5% - 10% percent of the liver’s weight is fat, then it is called a fatty liver (steatosis).

WHO IS LIKELY TO HAVE NAFLD?
NAFLD tends to develop in people who are overweight or obese or have diabetes, high cholesterol or high triglycerides. Rapid weight loss and poor eating habits also may lead to NAFLD.

However, some people develop NAFLD even if they do not have any risk factors. NAFLD affects up to 25% of people in the United States.

Read how Nick Giordano, a marathon runner, was diagnosed with NAFLD.

RISKS
NAFLD may cause the liver to swell (steatohepatitis). A swollen liver may cause scarring (cirrhosis) over time and may even lead to liver cancer or liver failure.

SYMPTOMS
NAFLD often has no symptoms.

When symptoms occur, they may include fatigue, weakness, weight loss, loss of appetite, nausea, abdominal pain, spider-like blood vessels, yellowing of the skin and eyes (jaundice), itching, fluid build up and swelling of the legs (edema) and abdomen (ascites), and mental confusion.

DIAGNOSIS
NAFLD is initially suspected if blood tests show high levels of liver enzymes. However, other liver diseases are first ruled out through additional tests. Often, an ultrasound is used to confirm the NAFLD diagnosis.

TREATMENT
There are no medical treatments yet for NAFLD. Eating a healthy diet and exercising regularly may help prevent liver damage from starting or reverse it in the early stages.

See a doctor who specializes in the liver regularly
Talk to your doctor about ways to improve your liver health
Lose weight, if you are overweight or obese
Lower your cholesterol and triglycerides
Control your diabetes
Avoid alcohol
PREVENTION
There are ways to prevent NAFLD:

Maintain a healthy weight
Eat a healthy diet
Exercise regularly
Limit alcohol intake
Only take medicines that you need and follow dosing recommendations.


NASH
The more severe form of NAFLD is called non-alcoholic steatohepatitis (NASH). NASH causes the liver to swell and become damaged. NASH tends to develop in people who are overweight or obese, or have diabetes, high cholesterol or high triglycerides. However, some people have NASH even if they do not have any risk factors.

Most people with NASH are between the ages of 40 and 60 years. It is more common in women than in men. NASH often has no symptoms and people can have NASH for years before symptoms occur.

NASH is one of the leading causes of cirrhosis in adults in the United States. Up to 25% of adults with NASH may have cirrhosis.

[flyinlynn]

Here is the info i copied that I promised

Hepatocellular Diseases of the Liver
There are many types of hepatocellular diseases ranging from infections and cancers. The liver is one of the biggest organs in the body and is located just underneath the right rib cage. The liver is also the powerhouse/engine of the body and plays a vital role in many functions like metabolism and breakdown of many substances. Without the liver, survival would be impossible.

What is hepatocellular disease?

The liver can be affected by infections, drugs or toxic chemicals. The majority of liver problems are transient or acute in nature because the liver has great healing power. However, chronic hepatocellular disease can last for a long time and present with a variety of symptoms. The classic symptoms of diffuse hepatocellular liver disease include:

• Yellowish discoloration of the skin and eyes
• Abdominal pain
• Distension of the abdomen
• Severe itching of skin
• Dark or tea colored urine
• Pale stools
• Intermittent blood in the stools
• Extreme fatigue
• Nausea
• Loss of appetite

There are many disorders that can cause chronic liver disease and these include:

– Alcohol induced liver damage
– Hemachromatosis (excess iron deposition in the liver tissues)
– Hepatitis A
– Hepatitis B
– Hepatitis C
– Hepatitis D
– Hepatitis E
– Parasitic infections
– Liver masses

o Adenomas, which are generally benign
o Hepatocellular cancer
o Cysts

Wilson’s disease (deposition of copper into the liver)

Risk factors for liver disease include:

– Exposure to infected body fluids or blood
– Blood transfusions
– Tattoos or body piercing
– Certain herbs (Black cohosh, ma-huang, Chaparral, Comfrey, Germander, Greater celandine, Kava, Mistletoe, Pennyroyal, Skullcap, Valerian)
– Prescription medications like acetaminophen
– Diabetes mellitus
– Excessive alcohol use
– Intravenous drug use and sharing needles
– Exposure to toxic chemicals
– Having unprotected sex

Diagnosis of hepatocellular disorders includes:

– Blood tests which can measure liver function and presence of infections like hepatitis. The blood tests can be used to follow the recovery after an infection or improvement in liver function.
– If any mass is suspected growing in the liver, then radiological tests like Ultrasound and CT scan are done
– Sometimes a liver biopsy may be required to determine the cause of liver problems. This small procedure can be done at the bedside using a small needle under local anesthesia.

The treatment of diffuse hepatocellular disease depends on the cause. While most cases can be treated with medications, some liver disorders may require surgery. If the liver is failing, the other option may be a liver transplant.

The best way to avoid liver disease is by preventing the problem in the first place. This means:

– Refraining from drinking excessive alcohol
– Avoiding promiscuous sexual behavior
– Avoiding use of intravenous drugs and sharing needles
– Avoiding tattoos and body piercing at unlicensed parlors
– Getting vaccinated with hepatitis B vaccine
– Using prescription medications wisely. Medications should not be mixed and not taken for prolonged time
– Avoiding contact with other people’s body fluids or blood. This also means avoiding sharing of personal care products.

Finally, one should eat healthy and exercise regularly. There are many causes of hepatocellular diseases, but by adopting a healthy life style, most of the disorders can be prevented.

[Careful35]

I had the ultra sound done that said I have hepatocelluar disease likely caused by fatty liver. What other testing do they do? My Dr made it sound like it's no big deal but it is a big deal to me esp with all the skin symptoms I have...
Did you have a bunch of skin symptoms?? I'm glad to hear you are doing well after diagnosis. That's awesome... I will see gastro on August 16th so hopefully get more answers then.

[flyinlynn]

I have never heard of  Hepatocellular disease so I googled it. Apparently it can be caused by many things but right now for you it is in likely the very early stages. The info I am posting talks about the condition andis for all the different senarios of causes so some information will apply but not everything like being careful if you are bleeding that would only apply to infectious causes like hep c or hep c. Your root cause is fatty liver I am assuming also called NAFLD for non alcoholic fatty liver disease which basically with proper diet weight loss and exercise you can stop this in its tracks and get back to having a healthy liver.

I have no skin symptoms persay I do have many raised red dots called cherry angioma so many it looks like a rash on my stomach I have had them  for many years and some spider angiomas but I don't really worry about them. But that's it.

Back in 2012 I had enlarged blood vessels in my esophagus (swallowing tube) that required banding to prevent a potentially life threatening bleed. I also have some lower leg swelling called edema which is due to portal hypertension because of how much liver damage I have. I also have a low platelet count for the same reason.

Testing for you would be liver enzymes which you already have had and con moleste blood count CBC. Also there is a test called a Fibroscan to try to determine the amount of liver damage you have. It is similar to an ultrasound but with a thump to determine liver stiffness. Another test to determine liver damage is called a Fibrosure which uses a blood test. The gold standard to determine liver damage because it is more accurate than Fibroscan and Fibrosure is a liver biopsy. But liver biopsies are an invasive test using a needle to take a sample of liver tissue.

Anyway when you see the  gastroenterologist I am sure he will be able to answer most of your questions and set you up for any additional testing to help with getting you diagnosed and on the way back to better health. One suggestion is to get copies of new testing you are having done so you can refer back later. My doctor uses a web site called "MyChart" where I can see my results any time.

[flyinlynn]

You are taking the right measures by trying to eat more healthy along with some exercise. Stopping drinking and reducing Tylenol to no more than the daily recommended dose are also good moves.

You won't know what is or is not going on with your liver until you see a specialist and get some tests done. But even if you do have fatty liver disease your liver with proper care can reduce the damage and return to normal.

The liver is a very tough organ. I was diagnosed with cirrhosis in 2008 from hep c and I am still around so what I am saying is don't panic. Just keep doing what you are doing and get in to see a hepatologist or at least a gastroenterologist to get properly diagnosed.

You will be ok believe it

Good luck