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I dont know whom to ask?

1 year back,I was healthy  with no any symptomes of liver disease .Then suddendly it all started with tenderness in the RUQ with a loss of appetite.I had black tar coloured stool and no motion for a week with a loss of appetite .I went to a gastro and told all the symtomes I had been suffering during the month .He did a palpation on my abdomen and told nothing is wrong and just had an endoscopy which does not sensed anything wrong but i know something is injuring my liver.I went for a bloodwork ,the result shocked me I had very high ALT 86 Normal is below 40 again went for an ultrasound result was echogenic liver .I had made major lifestyle changes after that  I drank 5 cups of coffee a day.I do not have any sugar carving .I restricted refined grains .After 1 year my ultrasound was all clear with no fatty liver ,but now I am getting symptomes of cirrhosis of liver like swelling in the leg ,insomania etc.I went to a gastro for that and told regarding my syptomes he wrote a battery of tests like USG,RUT,UGI Endoscopy,LFT,CBC hbsag,Hcv but again everything within range .I asked him whether he can write Fibroscan /liver biopsy to rule out cirrhosis?but he denied ..I am in a state of dillema .I dont know which stage I am at
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683231 tn?1467323017
Black tar stool could be bleeding yes that is correct but bleeding does not necessarily mean cirrhosis it could be ulcers amount other causes.

URQ pain is not that common in cirrhosis I have had cirrhosis for 11 years with no IRQ pain.

Found this about echogenic liver

“Ultrasound of the abdomen usually shows the liver is “echogenic,” that is more dense than usual toward sound waves. The liver can also be enlarged due to fat. Ultrasound does not really measure fat, but the great majority of the time an echogenic liver is found, this is related to excess fat.”

I found this about minimally elevated ALT

“More common causes of elevated liver enzymes include:

Over-the-counter pain medications, particularly acetaminophen (Tylenol, others)
Certain prescription medications, including statin drugs used to control cholesterol
Drinking alcohol
Heart failure
Hepatitis A
Hepatitis B
Hepatitis C
Nonalcoholic fatty liver disease
Obesity
Other causes of elevated liver enzymes may include:

Alcoholic hepatitis (severe liver inflammation caused by excessive alcohol consumption)
Autoimmune hepatitis (liver inflammation caused by an autoimmune disorder)
Celiac disease (small intestine damage caused by gluten)
Cytomegalovirus (CMV) infection
Epstein-Barr virus
Hemochromatosis (too much iron stored in your body)
Liver cancer
Mononucleosis
Polymyositis (inflammatory disease that causes muscle weakness)
Sepsis (an overwhelming bloodstream infection that uses up neutrophils faster than they can be produced)
Thyroid disorders
Toxic hepatitis (liver inflammation caused by drugs or toxins)
Wilson's disease (too much copper stored in your body)“

“Leg swelling related to fluid buildup. Leg swelling caused by the retention of fluid in leg tissues is known as peripheral edema. It can be caused by a problem with the circulatory system, the lymphatic system or the kidneys.”

“Swelling can have causes that aren't due to underlying disease. Examples include muscle injury, prolonged standing, or eating large amounts of salt.”


If all your tests are normal and a gastroenterologist believes you do not have cirrhosis I suggest you believe your doctor.

Your symptoms could be many things but as your tests per your doctor don’t indicate cirrhosis you symptoms are not from liver disease.

Work with your general practitioner and left them find the cause of your symptoms. They are the experts.
Helpful - 0
683231 tn?1467323017
Your other post said your upper endoscopy indicated you have an ulcer that is highly likely the cause of your tarry stool.

Per your doctors tecomnendations take the antibiotics if you have H pylori and the acid reducing meds to allow your ulcers to heal.

From all you have said I don’t feel you have liver disease and more importantly your doctor does not either.
Helpful - 0
3 Comments
I am dealing with insomania..Did your liver disease caused insomania?
It can as a symptom of very advanced liver disease. Sleep reversal is a possible symptom of hepatic encephalopathy. HE is a symptom of very advanced liver disease when the liver is beginning to fail completely.

However there are many reasons people develop insomnia. Insomnia is a very common condition.

“What is the main cause of insomnia?
Anxiety, stress, and depression are some of the most common causes of chronic insomnia. Having difficulty sleeping can also make anxiety, stress, and depression symptoms worse. Other common emotional and psychological causes include anger, worry, grief, bipolar disorder, and trauma.”
If you are suffering from insomnia, there are many steps you can take to change behaviors and lifestyle to help you get to sleep. Here are some tips for beating insomnia.

Wake up at the same time each day. It is tempting to sleep late on weekends, especially if you have had poor sleep during the week. However, if you suffer from insomnia you should get up at the same time every day in order to train your body to wake at a consistent time.

Eliminate alcohol and stimulants like nicotine and caffeine. The effects of caffeine can last for several hours, perhaps up to 24 hours, so the chances of it affecting sleep are significant. Caffeine may not only cause difficulty initiating sleep, but may also cause frequent awakenings. Alcohol may have a sedative effect for the first few hours following consumption, but it can then lead to frequent arousals and a non-restful night's sleep. If you are on medications that act as stimulants, such as decongestants or asthma inhalers, ask your doctor when they should best be taken to help minimize any affect on sleep.

Limit naps. While napping seems like a proper way to catch up on missed sleep, it is not always so. It is important to establish and maintain a regular sleep pattern and train oneself to associate sleep with cues like darkness and a consistent bedtime. Napping can affect the quality of nighttime sleep.

Exercise regularly. Regular exercise can improve sleep quality and duration. However, exercising immediately before bedtime can have a stimulant effect on the body and should be avoided. Try to finish exercising at least three hours before you plan to retire for the night.

Limit activities in bed. The bed is for sleeping and having sex and that's it. If you suffer from insomnia, do not balance the checkbook, study, or make phone calls, for example, while in bed or even in the bedroom, and avoid watching television or listening to the radio. All these activities can increase alertness and make it difficult to fall asleep.

Do not eat or drink right before going to bed. Eating a late dinner or snacking before going to bed can activate the digestive system and keep you up. If you suffer from gastroesophageal reflux (GERD) or heartburn, it is even more important to avoid eating and drinking right before bed since this can make your symptoms worse. In addition, drinking a lot of fluids prior to bed can overwhelm the bladder, requiring frequent visits to the bathroom that disturb your sleep.

Make your sleeping environment comfortable. Temperature, lighting, and noise should be controlled to make the bedroom conducive to falling (and staying) asleep. Your bed should feel comfortable and if you have a pet that sleeps in the room with you, consider having the pet sleep somewhere else if it tends to make noise in the night.

Get all your worrying over with before you go to bed. If you find you lay in bed thinking about tomorrow, consider setting aside a period of time -- perhaps after dinner -- to review the day and to make plans for the next day. The goal is to avoid doing these things while trying to fall asleep. It is also useful to make a list of, say, work-related tasks for the next day before leaving work. That, at least, eliminates one set of concerns.

Reduce stress. There are a number of relaxation therapies and stress reduction methods you may want to try to relax the mind and the body before going to bed. Examples include progressive muscle relaxation (perhaps with audio tapes), deep breathing techniques, imagery, meditation, and biofeedback.

Consider participating in cognitive therapy. Cognitive therapy helps some people with insomnia identify and correct inappropriate thoughts and beliefs that may contribute to insomnia. In addition, cognitive therapy can give you the proper information about sleep norms, age-related sleep changes, and help set reasonable sleep goals, among other things.
Avatar universal
UQR pain is something that many people with liver disease experience but everybody is different. I also have liver disease and I have the pain also in the left upper side. You can go to many sites and most people feel the nerves around the liver when it is inflamed. Your doctor has done most of the necessary work to put you at ease with your liver but a biopsy is considered the gold standard. I wouldn't have a liver biopsy because there is a great risk of bleeding and infection. Live your life and I hope you get some relief from your pain.
Helpful - 0
9 Comments
Does ALT,AST or others liver function tests signifies imflammation?I had LFT which came pretty normal .My Doctor interpreted as very much normal.
Does ALT,AST or others liver function tests signifies imflammation?I had LFT which came pretty normal .My Doctor interpreted as very much normal.
Klause01 you said left side pain. Are you saying a reference pain? Im not sure what you mean as the liver is located on the right.
Elevated liver enzymes mean something is bothering your body not jest your liver. Heart problems can also cause rises in liver enzymes as well as taking OTC pain meds in normal dosages.

Your body produces various enzymes in the normal process of tissue repair. Inflamation is a different physical process.

You have normal liver enzymes and your doctor says you are fine I suggest you trust your doctors expert medical opinion.

As far as possible causes for elevated liver enzymes however none f these should be a concern for you as your liver enzymes are normal.

“ Causes
By Mayo Clinic Staff
Many diseases and conditions can contribute to elevated liver enzymes. Your doctor determines the specific cause of your elevated liver enzymes by reviewing your medications, your signs and symptoms and, in some cases, other tests and procedures.

More common causes of elevated liver enzymes include:
Over-the-counter pain medications, particularly acetaminophen (Tylenol, others)
Certain prescription medications, including statin drugs used to control cholesterol
Drinking alcohol
Heart failure
Hepatitis A
Hepatitis B
Hepatitis C
Nonalcoholic fatty liver disease
Obesity
Other causes of elevated liver enzymes may include:

Alcoholic hepatitis (severe liver inflammation caused by excessive alcohol consumption)
Autoimmune hepatitis (liver inflammation caused by an autoimmune disorder)
Celiac disease (small intestine damage caused by gluten)
Cytomegalovirus (CMV) infection
Epstein-Barr virus
Hemochromatosis (too much iron stored in your body)
Liver cancer
Mononucleosis
Polymyositis (inflammatory disease that causes muscle weakness)
Sepsis (an overwhelming bloodstream infection that uses up neutrophils faster than they can be produced)
Thyroid disorders
Toxic hepatitis (liver inflammation caused by drugs or toxins)
Wilson's disease (too much copper stored in your body)“
One additional comment about liver enzymes. I have had liver cirrhosis for 11 years. My liver enzymes are normal.

They were elevated when I had hepatitis c as the virus was constantantly actively attacking my liver. But since my hep c was cured theecis nothing attacking my liver so my liver enzymes are normal.

There is no correlation to liver enzymes and amount of liver damage or inflamation.
The new gold standard is a relatively new test called a Fibroscan. It is non invasive and required no down time as opposed to a liver biopsy where a large needle is inserted into the liver.

There has been shown to be a good correlation to liver damage estimates using a Fibroscan machine when compared with liver biopsy results especially in the low damage range and higher damage. It is slightly less accurate in mid range damage of F2 and F3
Yes, i know the liver is located on the right side but I also have pain on the left side where the spleen is located, it is mildly enlarged
Ok just wanted to be sure what you are experiencing. I have heard that sometimes you can get reflexive pain in other parts of your body.
Yes, it could be that but my liver is mildly enlarged, most say you can't feel an enlarged spleen and it only hurts when you breathe but mine pain when I eat also sometimes when i am just sitting. Mine hurt mostly in the front under the ribcage not towards the back and sometimes closer to the belly button, this is because it is inflamed. I think ASH FIbersore is the best test to detect stiffness.
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