Am I experiencing liver disease? please help

[Tim1130]

Hello. I am a 29 year old heavy drinker and have been for around 10 years. I am very into exercising and weight lifting. a couple of years ago I took a legal supplement to help improve my results at the gym. While using, I continued to consume heavy amounts of alcohol. I also noticed that I experienced sharp pains in my upper right quadrant. A physical showed abnormal LFTs. A follow up exam revealed that they had returned to normal, and I continued another cycle. I experienced the pains again but LFTs were normal. I found out that the supplement is toxic to the liver so I stopped taking immediately. I continued drinking heavily with no pains until this April. I noticed that my right rib cage and just underneath was severely tender. I went to the hospital- enzymes were fine and imaging was normal, They said pains were from constipation that I was also experiencing.The constipation was relied but the pain continued and I continued to drink- My doctor said that my liver is absolutely fine. When I don't drink the pain goes away, but I continue to drink moderately, I have noticed several different types of pain that range from itchy and irritating to dull and nagging, as well as sharp biting pains. I have also started to notice confusion and disorientation. I mix up words and find it difficult to communicate sometimes. I just returned from a business trip where I drank relatively moderately with a couple nights of excess, and my pain/ symptoms have never been worse. I have a doctors appointment scheduled, but my doctor acts like I am crazy when I communicate my liver concerns. My question is: is it possible to have liver disease when all tests (imaging and LFTs) return normal results? And if so how far along could I possibly be. I plan to stop drinking for a while but cutting alcohol out of my life would require me to cut many important people out of my life as well, and also change my career path which I love and really do not want to do. Any help is much appreciated.

[Christopher R Watters, MD]

Just because your liver is anatomically normal doesn't mean that you don't get alcoholic hepatitis with drinking. I am proud of you for the abstinance as I am sure you are. The best outcome is to continue and stop the damage. Whatever the current state of your liver, this will give you the best chance of a normal life expectancy.

[Tim1130]

Thank you again for your previous reply. Since my last post I saw a GI and had a CT scan. The results were normal. Blood work remains normal and the GI said that my liver is fine. I have not had a drink for about 3 weeks and the pain is just about gone. I just want to understand how my liver can be "fine" but I continue to experience what are believed to be liver pains when I drink. Is there an explanation? She didn't really bring me to any conclusion. Thanks again

[Christopher R Watters, MD]

Abstinence will stop the ongoing damage and allow some healing. As for the long term prognosis, this would depend on how much damage has been done. A liver biopsy can usually determine the amount of scarring that has developed.

[Tim1130]

Thank you for your response. My continuation of alcohol consumption is due to environmental circumstances (work, social) as well as the previous diagnosis from my doctor. That is why I am so worried. In order for me to stop drinking completely, I have to make many life changes. And it seems like I will have to do so. I have read conflicting information regarding the prognosis of alcoholic hepatitis ranging from reversibility to fatality. How severe is this condition, and will abstinence completely cure me if I am experiencing alcoholic hepatitis? Thank you again for this information.    

[Christopher R Watters, MD]

I have to ask the obvious. If you stopped some supplement because it might be harmful to your liver why do you continue to insult your liver with alcohol? What you are asking is how much poison is too much. It sounds like you are describing bouts of alcoholic hepatitis. The liver has a pretty impressive ability to heal and regenerate. It is when these processes are overcome by the toxic inflammation that the labs finally become abnormal.