Aa
Do I have liver disease?
I went to the doctor with complaints of dizziness, some nausea
and unusual vaginal bleeding. The bleeding has since subsided
and the only symptoms I have now are fatique, light colored
stools and dizziness. My lft, ultrasound and CT scan were all
negative. Do you suspect liver disease?
and unusual vaginal bleeding. The bleeding has since subsided
and the only symptoms I have now are fatique, light colored
stools and dizziness. My lft, ultrasound and CT scan were all
negative. Do you suspect liver disease?
MEDICAL PROFESSIONAL
There can be many diseases that can lead to your symptoms.
However, if the LFTs, ultrasound and CT scan are all normal, it is unlikely that liver disease is present. You can continue to further evaluate the gallbladder with a HIDA scan to complete the evaluation.
The dizziness can be evaluated via neurology evaluation and possible brain imaging. Nausea can be initially evaluated with an upper GI series and/or upper endoscopy.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
However, if the LFTs, ultrasound and CT scan are all normal, it is unlikely that liver disease is present. You can continue to further evaluate the gallbladder with a HIDA scan to complete the evaluation.
The dizziness can be evaluated via neurology evaluation and possible brain imaging. Nausea can be initially evaluated with an upper GI series and/or upper endoscopy.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
I forgot to mention I also have red spider angiomas and
nausea
nausea
Dizziness and nausea? I don't think dizziness is a symptom of liver disease is it? With all your negative tests i'm just curious why you are concerned about liver disease.The dizziness and nausea could be realted to an inner ear problem or to many other things.
Linda J
Linda J
You have every symptom of a liver issue going on, I'd get tested for hepatitis right away ( a, b and definately c) and have your liver enzymes monitored. See a Heptologist if you can, they are liver specialists there could be a lot of reasons, you need a good liver doc.
The spider nevi are a sign of liver issues too as are all the symptoms you mention including the nausea.
good luck, hope you find out soon what is going on.
The spider nevi are a sign of liver issues too as are all the symptoms you mention including the nausea.
good luck, hope you find out soon what is going on.
I wanted to add that having a "clear" CT scan or ultrasound really doesn't tell you much other than you don't have any tumors or masses, which is good of course, but the gold standard to determine liver damage is a biopsy and only a biopsy. You can have normal enzymes and have cirrhosis for example, so don't go by just within range enzymes.
How were your platelets?
How were your platelets?
No doctor will order a biopsy of the liver, in my opinion, absent abnormal lfts, cat scans, and ultrasound. You are needlessly alarming. Yhis can be the result of other issues than the liver.
While a liver biopsy is the "gold standard", no doctor is going to order a liver biopsy based on normal LFT's and ultrasound. It would be highly unlikely to have liver disease with these 2 things being completely normal. A liver biopsy is highly invasive. This isn't something one undertakes lightly.
I'd say she needs to get the unusual vaginal bleeding evaluated by a good gyne. But, to jump to a liver biopsy based on what she posted is overkill.
Linda J
I'd say she needs to get the unusual vaginal bleeding evaluated by a good gyne. But, to jump to a liver biopsy based on what she posted is overkill.
Linda J
She has symptoms of liver illness, light stools, nausea, fatigue and you CAN indeed have cirrhosis and not have elevated enzymes. She needs to be tested for all heps and be screened for other liver disorders and gallbladder problems, etc. Many go undiagnosed or misdiagnosed with liver problems. I know, it happened to me and I had the very same symptoms as she does. I said biopsy is the only way to determine her liver condition,I didn't say she should run out and get one just that she needs to understand that "silent killer" diseases do not always make themselves obvious. She needs a Heptologist or Gastro to look further and I agree it could be something else but she needs someone to look further. What are her platelets doing? If they are low that is another sign of liver problems, she needs to be evaluated more thoroughly. I agree she needs to also see a GYN to evaluate the vag. bleeding, but that too COULD be related to liver issues, particularly if she has hep.it can mess up your cycle causing spotting. That happened to me also.
It is not good to judge by enzymes alone to determine a liver issue especially when the person is symptomatic like she is and to suggest that if her enzymes arent elevated nothing is wrong with her liver is not correct, enzymes do not tell the whole story.
It is not good to judge by enzymes alone to determine a liver issue especially when the person is symptomatic like she is and to suggest that if her enzymes arent elevated nothing is wrong with her liver is not correct, enzymes do not tell the whole story.
PS. her spider angiomas are also a sign of cirrhosis and/or some other liver issue, she has all the earmarks of a liver problem even if she has a clear untrasound and CT scan, those tests can't determine if she has cirrhosis either. I sure hope she gets a liver speciailists opinion and doesn't have to wait until her symptoms are worse to find out what is going on.
My vag. bleeding was one of the things that threw the docs off the scent thinking it was a gyn issue, in the end after many months of sickness I finally saw a gastro who put it together right away.
My vag. bleeding was one of the things that threw the docs off the scent thinking it was a gyn issue, in the end after many months of sickness I finally saw a gastro who put it together right away.
You can indeed have cirrhosis with normal enzymes and cat scan, but is it LIKELY she has that with normal tests? Fine, test for hepatitis, but his could be gallbladder as well, as she has not had a hida scan as of yet.
I agree, a hida scan would help too.
I know that the symptoms could be indicative of something else entirely, I just hope she gets to a specialist and gets some answers.
The spider nevi are a big tip off to it being liver related and you can also have a liver issue that can aggravate the gallbladder, they can go hand in hand so she should have both investigated. Many people with Hep develop gallbladder problems.
Didn't mean to be alarmist when I mentioned a biopsy, but many people think all is "ok" because they have a clear untrasound or CT scan and with liver problems, that just isn't the case, they can't see fibrosis or cirrhosis with those tests.
They don't tell the patient that little fact and the patient might have a false sense the liver is fine when it is not.
I know that the symptoms could be indicative of something else entirely, I just hope she gets to a specialist and gets some answers.
The spider nevi are a big tip off to it being liver related and you can also have a liver issue that can aggravate the gallbladder, they can go hand in hand so she should have both investigated. Many people with Hep develop gallbladder problems.
Didn't mean to be alarmist when I mentioned a biopsy, but many people think all is "ok" because they have a clear untrasound or CT scan and with liver problems, that just isn't the case, they can't see fibrosis or cirrhosis with those tests.
They don't tell the patient that little fact and the patient might have a false sense the liver is fine when it is not.
Yes, you CAN have liver disease with normal scans and LFT's. But, my gastro said it would occur less than 5% of the time. Her spider veins can also be caused by sun damage. My hubby has them and has no liver disease. No offense, but you seem to want to "diagnose" everyone with cirrhosis. Lots of conditions have similar symptoms.
Linda J
Linda J
Just curious, how did your vaginal bleeding figure into a diagnosis of liver disease?
Linda J
Linda J
that's ridiculous, I didn't do any such thing. She asked if anyone thought her symptoms sounded like a liver issue and they do.
No offense, but you should read through more thoroughly before you go off accusing people of trying to diagnose someone which I certainly did not do. A gyn might help her with that one issue, what about all the other ssymptoms she mentions? You would just ignore those and suggest she just see a gyn for vaginal bleeding? I say she needs more extensive testing and to see a Gastro too.
Many people dont know they have a liver issue until it is advanced so she is smart to check it out.
No offense, but you should read through more thoroughly before you go off accusing people of trying to diagnose someone which I certainly did not do. A gyn might help her with that one issue, what about all the other ssymptoms she mentions? You would just ignore those and suggest she just see a gyn for vaginal bleeding? I say she needs more extensive testing and to see a Gastro too.
Many people dont know they have a liver issue until it is advanced so she is smart to check it out.
Wouldn't a cat scan or ultrasound SUGGEST fibrosis or cirrhosis though? I know this can only be diagnosed with a biopsy, but every doc I have talked to thinks the cat would catch any changes to the liver, ie if the liver was enlarged or smaller, or if there was changes in the structure. No test is perfect, but did you have liver problems with normal cat scan and lfts?
I was told they can't detect it without a biopsy although I hear they are testing a new machine that is in trials now "Fibroscan" this is supposed to be able to detect it without having to biopsy.
Not sure why you are so touchy. I know quite a bit about liver issues since I went thru extensive testing (about $3000 worth) myself recently. Dizziness is not a symptom of liver disease. That could be anemia or something neurological.
Again, with normal scans and normal LTF's it is UNLIKELY she has liver disease. You seem to not want to address that.
LInda J.
Again, with normal scans and normal LTF's it is UNLIKELY she has liver disease. You seem to not want to address that.
LInda J.
I just went thru extensive testing by a well respected gastro specialist. He said exactly what muckman posted, while cirrhosis cannot definitively be diagnosed by CT or ultrasound, it is usually "strongly suggested" by these tests.
It is typically end stage cirrhosis that presents with normal liver enzymes. By that time the patient is exhibiting other symptoms like jaundice and ascites.
Were you diagnosed with cirrhosis after normal LFT's and ultrasound?
Linda J.
It is typically end stage cirrhosis that presents with normal liver enzymes. By that time the patient is exhibiting other symptoms like jaundice and ascites.
Were you diagnosed with cirrhosis after normal LFT's and ultrasound?
Linda J.
I had my gallgladder removed in Marh due to stones. 2 weeks after sugery I had a severe attack, almost like the gallbladder attacks. I took pain meds and reported this to my surgeon during my follow-up post-op vist. He said to give it some time. It has been almost 2 months and I have been experiencing pain on the right upper abdomen. In additon to the daily pain, I get severe nausea, w/o vomiting with the exception of 2 occaisions. A couple of weeks I called and they sent me for a CT Scan of the abdomen. I receieved a call the other day and the Dr said everything is fine. I was very surpised because I am still having daily pain and nausea, I am worse off now than prior to my surgery, at least prior I had breaks in between attacks.
I also had the Xray office send me a copy of my report. In my report it states that there is a 4mm lesion on the left lobe of the liver, the etiology is unclear, possibly a hemangioma. Also states that there is mild ectasia of the bile duct which can be seen post cholecystectomy. At the conclusion it states Indeterminate lesion in the liver. Is this all normal, don't I require follow-up? Why would surgeon who performed cholecystectomy say that my results were normal. I am confused.
Meanwhile I have to live with the daily on and off sharp and sometimes crampy pani and several episodes of nausea EVERY DAY.
Any feedback?
I also had the Xray office send me a copy of my report. In my report it states that there is a 4mm lesion on the left lobe of the liver, the etiology is unclear, possibly a hemangioma. Also states that there is mild ectasia of the bile duct which can be seen post cholecystectomy. At the conclusion it states Indeterminate lesion in the liver. Is this all normal, don't I require follow-up? Why would surgeon who performed cholecystectomy say that my results were normal. I am confused.
Meanwhile I have to live with the daily on and off sharp and sometimes crampy pani and several episodes of nausea EVERY DAY.
Any feedback?
First I apologize to the original poster, for this was your thread! Valley GO to another gastro please, if for nothing else for peace of mind!! Many times a Dr. will say normal when there are a few "little" abnormalities on the test!!
I also had my GB out and have more problems, if you want to
e-mail me ***@****
Again sorry that we posted our own thread. Also to the original
poster, Why not just seek a 2nd opinion with a hematologist, just to put your mind at ease!
I also had my GB out and have more problems, if you want to
e-mail me ***@****
Again sorry that we posted our own thread. Also to the original
poster, Why not just seek a 2nd opinion with a hematologist, just to put your mind at ease!
I think you are the one attempting to diagnose this woman. There are many liver conditions she should be evaluated for with her symptoms. Cirrhosis is not the ONLY liver problem there is. You are in no position to tell her what is or is not going on in her liver and she deserves toknow and rule out liver issues and hepatitis to try to solve her symptoms.
And regarding your doctors telling you you are fine and everything is rosy, unless she has a crystal ball she can't say with any certainty that you definately have no liver scarring.
Here, if you don't believe me, maybe you will believe experts on the subject:
"The onset of cirrhosis is usually silent, with few specific symptoms to identify this development in the liver. As scarring (fibrosis) and destruction continue, some of the following signs and symptoms may occur: loss of appetite, nausea and/or vomiting, weight loss, change in liver size, gallstones, itching, and jaundice. However, a large number of people live many, many years with cirrhosis without any decompensation or symptoms."
And regarding your doctors telling you you are fine and everything is rosy, unless she has a crystal ball she can't say with any certainty that you definately have no liver scarring.
Here, if you don't believe me, maybe you will believe experts on the subject:
"The onset of cirrhosis is usually silent, with few specific symptoms to identify this development in the liver. As scarring (fibrosis) and destruction continue, some of the following signs and symptoms may occur: loss of appetite, nausea and/or vomiting, weight loss, change in liver size, gallstones, itching, and jaundice. However, a large number of people live many, many years with cirrhosis without any decompensation or symptoms."
If you paid 3,000 to a gastro for "liver evaluation" and all you got was your bloodwork done and your LFT's evaluated and an ultrasound? I am curious what you got for that large amount of money?
The big money goes into the CT scan costs I guess but a CT scan isn't the best tool for liver evaluation and in my view is a waste of money unless there was a specific reason, a suspected growth or something. Did you have symptoms to warrant the evaluation? If you needed an evaluation of your liver, why wouldn't you see a Heptologist and not a Gastro? Believe what you want but the truth is what I stated and even WITH a biopsy you can be cirrhotic in one area of your liver and fine in another, so even a biopsy is not telling the entire story.
The only way to examine the whole liver is an autopsy and I doubt you have had one of those.
You accused me of "diagnosing" someone here, that is why I was "touchy" you should watch what you say. You are the one who is telling her she is fine in SPITE of her symptoms and she has quite a few symptoms she is coping with,so clearly she isn't "fine" she needs to be tested for Hepatitis, all types of it and she needs to get to the bottom of her symptoms.
The big money goes into the CT scan costs I guess but a CT scan isn't the best tool for liver evaluation and in my view is a waste of money unless there was a specific reason, a suspected growth or something. Did you have symptoms to warrant the evaluation? If you needed an evaluation of your liver, why wouldn't you see a Heptologist and not a Gastro? Believe what you want but the truth is what I stated and even WITH a biopsy you can be cirrhotic in one area of your liver and fine in another, so even a biopsy is not telling the entire story.
The only way to examine the whole liver is an autopsy and I doubt you have had one of those.
You accused me of "diagnosing" someone here, that is why I was "touchy" you should watch what you say. You are the one who is telling her she is fine in SPITE of her symptoms and she has quite a few symptoms she is coping with,so clearly she isn't "fine" she needs to be tested for Hepatitis, all types of it and she needs to get to the bottom of her symptoms.
from what ive looked into yes both can be normal with cirrhosis
but if you had cirrhosis your symptoms would be alot worse.
But i have a question for you two. I have normal lft and had a normal cat scan last month. I also had a biopsy that showed
last year that reads minimal fibrosis, slight portal tract imflammion, and slight fatty liver, with moderate iron present.
After the biopsy i was on meds trazadone and clonapine for 3 months and took them both everyday. I was a heavy drinker for 20 years. Now i have all they symptoms of cirrhosis- stomach bloats,
red palms, weight loss, confused, loss of appitite, private parts shrunk, also severe dry mouth. Ive been back to 2 gastros and my primary doctor. They look at my biopsy and say yes it shows damage but not severe. I tell them that i think the meds i was no made my liver worse they all do not agree with me because my lft and cat scan came back normal last month. I have the history of drinking and then the meds i took. I had alot of symptoms before the biopsy mostly weight loss. First you mentioned the biopsy can be wrong as far a what piece of liver they took. I think my damage was worse to start with. It seems the gastro and primary doctors do not know everything about the liver. I ask some qustions and they do not know. I have and appointed with a hepatoligist in 2 months. They tell me this doctor just does the liver and also deals with transplants.
Do you think he is my best bet to see. What test should i ask for . Someone mentioned a test that tells how the whole liver is doing not just a little piece. Also when i got my first symptoms my lft were sky high. They are normal now that i dont drink.
Are their better blood test to get. Thanks
but if you had cirrhosis your symptoms would be alot worse.
But i have a question for you two. I have normal lft and had a normal cat scan last month. I also had a biopsy that showed
last year that reads minimal fibrosis, slight portal tract imflammion, and slight fatty liver, with moderate iron present.
After the biopsy i was on meds trazadone and clonapine for 3 months and took them both everyday. I was a heavy drinker for 20 years. Now i have all they symptoms of cirrhosis- stomach bloats,
red palms, weight loss, confused, loss of appitite, private parts shrunk, also severe dry mouth. Ive been back to 2 gastros and my primary doctor. They look at my biopsy and say yes it shows damage but not severe. I tell them that i think the meds i was no made my liver worse they all do not agree with me because my lft and cat scan came back normal last month. I have the history of drinking and then the meds i took. I had alot of symptoms before the biopsy mostly weight loss. First you mentioned the biopsy can be wrong as far a what piece of liver they took. I think my damage was worse to start with. It seems the gastro and primary doctors do not know everything about the liver. I ask some qustions and they do not know. I have and appointed with a hepatoligist in 2 months. They tell me this doctor just does the liver and also deals with transplants.
Do you think he is my best bet to see. What test should i ask for . Someone mentioned a test that tells how the whole liver is doing not just a little piece. Also when i got my first symptoms my lft were sky high. They are normal now that i dont drink.
Are their better blood test to get. Thanks
If you are still concerned I think seeing a Heptologist is a good move. If you have stopped drinking that is the best thing you can do for your liver. Fatty liver can be controlled and reversed with a good healthy liver friendly diet and proper excercise. Your liver can heal itself if it isn't being assaulted with booze and poor diet and lack of exercise.If it is not cirrhotic you can reverse damage to the liver, the liver is a very forgiving organ. Fatty liver should be addressed and dealt with with the above mentioned regimen, discuss it with the liver specialist.
You can live a long life even if your liver has sustained some permanent damage so try not to worry too much. Anxiety can cause many symptoms even physical ones so you might want to address your anxiety if you worry far too much about it. You stop the behaviors that are causing the liver problem and you are on the right track.
I wouldn't assume the meds you took have damaged your liver unless you have some evidence that is true, you didn't take them very long and you don't take them now so I wouldn't worry.
You can live a long life even if your liver has sustained some permanent damage so try not to worry too much. Anxiety can cause many symptoms even physical ones so you might want to address your anxiety if you worry far too much about it. You stop the behaviors that are causing the liver problem and you are on the right track.
I wouldn't assume the meds you took have damaged your liver unless you have some evidence that is true, you didn't take them very long and you don't take them now so I wouldn't worry.
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