Worried about Cirrhosis

[JT855]

To whom it may concern,

I'm a 26 year old male who has been drinking heavily for the past 5 years. Yes, I'm quite aware that I should see a doctor soon but I have to wait until I can afford health insurance. I hope to get a piece of mind through this forum.

Recently, I've been experiencing pain in the upper right back quadrant and some in the front in the same area. The skin area is tender and just discomfortable without too much pain. In addition, I've been getting sore muscles that are from unknown causes, particularly in the arms. Also, I have been recently been fatigued from time to time and getting nosebleeds (not too violently) that keep popping up this past week, even though i've received cuts from moving that healed fine in addition with being able to move my stuff without much fatigue. As of now, I've noticed that my stools are black. When I eat, I do get mild pain on my back behind my liver/gallbladder area. I'm worried that this might be either cirrhosis/ gallbladder issue/pancreatitis. Besides my symptoms, I have no signs of Jaundice, swelling of my feet, skin itching, nausea, vomiting, not much loss of appetite or spider veins which do point out to cirrhosis. I feel that I have a very slight mental fog but generally able to think alright.

In the mean time, I'm taking steps to refrain from drinking alcohol by stopping consumption but not completely abstaining (drinking once a week). I'm probably going to get advice to stop drinking completely but as of now, I am more than willing to take a long break from it for sure as I can definitely put it off. I have been diagnosed with fatty liver in the past and I'm aware that my AST/ALT numbers are high (don't know exact numbers).

Please help, thanks!

[Dr. Kokil Mathur]

Hi!

As you probably already know, right upper abdominal pain can be due to cholecystitis (inflammation of gall bladder), stones in gall bladder, abscess under the diaphragm, liver problems or due to duodenal ulcer.

Since you drink alcohol there can be two possibilities, one is alcoholic hepatitis and the other is gastritis with or without duodenal ulcer. Fatty liver could be the cause behind high AST/. However, alcoholic hepatitis of mild type not causing any appreciable jaundice and presenting only as muscle aches is also a possibility. If possible get complete liver function tests done. The one good thing about alcoholic hepatitis is that the road to recovery begins as soon as you stop drinking. So give up drinking completely for a few days and see if it helps.

Gastritis would respond to antacid gel, proton pump inhibitor like omeprazole or lansprazole and medications like ranitidine. You can eat light diet without much oil and spices, avoid alcohol, smoking, coke and other carbonated drinks. Drinking cold milk and eating small frequent meals will also provide some relief.

Also, if you have bowel problems like constipation or diarrhea then you could also be suffering from Crohn’s disease, celiac disease, IBS and food intolerance should also be considered. Log in what you eat and the symptoms as they appear and see which food items cause the pain and tenderness to aggravate. Until you can consult a doctor, abstain from food items that cause you more pain than others.

If you have foul smelling , oily or greasy stools then pancreatitis also needs to be ruled out through blood tests and imaging studies.

I am sorry, but a confirmed diagnosis is not possible on net. A comprehensive investigation is required keeping all the above points in mind. Please try and consult a doctor regarding this. Hope you get well soon! Good Luck and take care!

[JT855]

In addition, Alcoholic Hepatitis is of concern to me as well. Earlier, when I mentioned skin discomfort, I mean at the back area behind my liver/gallbladder. There is no sign of bruising. In addition, my palms of my hands are of normal reddish hue.