Posted By Jack on June 09, 1999 at 15:07:53
I used to be a heavy drinker several years ago, a few years of anywhere from 4 to 12 drinks per day. The last 5 or 6 years have been more like several beers twice a week, ususally on weekends or special occasions, but consumption has decreased drastically. January of this year I quit drinking completely and have not touched a drop since. During the past four months I have been experiencing occasional right upper quadrant discomfort, alternating with periods of itching from head to toe. The pain usually is mild and lasts two to three days. The itching lasts anywhere from 1.5 to 4 weeks. Then there is no itching for about 1.5 to 2 weeks before it returns. I have not had jaundice. I've had no other symptoms except an occasional short spell of diarrhea, independent of the pain and itching. My questions are as follows: 1) With the absence of jaundice, is it still likely that my itching (pruritis?) is due to a liver problem? Does pruritis usually occur without the presence of jaundice? I have no skin rashes or other apparent skin problems. 2) Is the absence of some of the more serious liver dz. sysmptoms (GI bleeding, Nausea/Vomiting, constant diarrhea, fatigue, mental dysfunction etc.) a positive sign? If I abstain completely from alcohol, is this problem likely to get worse or stabilize? Is it possible that I have only Alcoholic Hepatitis and not Cirrhosis? If so, would it be normal for these symptoms to last 4 or 5 months? 3) Lastly, is there anything that I can do to relieve the pruritis? Any over the counter or herbal/food supplement remedies? I have not been to a doctor due to insurance issues but would like some qualified opinion. Please HELP! This is worrying me to death!
Posted By HVMA Gastro MD-FWR on June 21, 1999 at 17:08:24
Thank you for your question regarding pruritus and liver disease. Pruritus is a very nonspecific symptom and may be related to a number of conditions including liver disease. Pruritus is commonly seen in patients with jaundice, but can be a symptom even in the setting of a normal bilirubin. Many patients with alcoholic liver disease can stablize their condition by abstaining from alcohol. I cannot stress enough the need for you to follow up with a physician regarding your condition. Advice in the absence of other data (lab studies) is not wise. Discontinuation of alcohol ingestion is the most important behavioral modification and you should be congratulated for having accomplished that lifestyle change. Sincerely, FWR
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