Aa
Cirrhosis?
47 y/o male with history (sober 2 years) of heavy alcohol use. 3 years ago started mild RUQ pain. No other problems other than occasional constipation. Went to Dr and after US, CT, Bone Scan, MRI, UGI, Colonoscopy (all negative), finally HIDA. Indicated surgery, even though no "attacks". Gall bladder removal in April of 05.
In July of 05 started itching all over body. Not every day but more than not. Find it is worse when I am not very active. When I get out work up a sweat in any way I notice itching is either better or non-existent.
Went back to Dr. who did another CT (Neg). Even had a Radiologist friend look at the pictures. Said everything looked fine.
Then about 1 year ago I started noticing not only the itching but my palms turn red as well. They seem to wax and wane, being more red in the evenings. Some days they just appear "mottled." Other times they are so red (especially after I shower or wash my hands) I am very self-conscious about them.
Went to a new Gastro. Told him about my history (including alcohol) and asked him if he thought it could be cirrhosis. He examined me head to toe, did LFT's and called back saying everything is normal, stop worrying.
I had trouble doing that because the itching and red palms remained the same. So I went to another Gastro last month. Ordered LFT's and US. Results were "fine". Nothing to worry about. Told me I should go see a Derm. for the itching.
Itching continues. Red palms continue. Appetite is fine. Not losing/gaining weight. Nothing else really seems to be wrong and I'm overall pretty healthy. Still have the mild RUQ pain that started this several years ago but everyone says to stop worrying about it.
My question: Could this still be cirrhosis? The only thing Red palms and itching together seem to match in any of the things I've read are cirrhosis and PV. I don't seem to have any of the other symptoms of either of those things however.
In July of 05 started itching all over body. Not every day but more than not. Find it is worse when I am not very active. When I get out work up a sweat in any way I notice itching is either better or non-existent.
Went back to Dr. who did another CT (Neg). Even had a Radiologist friend look at the pictures. Said everything looked fine.
Then about 1 year ago I started noticing not only the itching but my palms turn red as well. They seem to wax and wane, being more red in the evenings. Some days they just appear "mottled." Other times they are so red (especially after I shower or wash my hands) I am very self-conscious about them.
Went to a new Gastro. Told him about my history (including alcohol) and asked him if he thought it could be cirrhosis. He examined me head to toe, did LFT's and called back saying everything is normal, stop worrying.
I had trouble doing that because the itching and red palms remained the same. So I went to another Gastro last month. Ordered LFT's and US. Results were "fine". Nothing to worry about. Told me I should go see a Derm. for the itching.
Itching continues. Red palms continue. Appetite is fine. Not losing/gaining weight. Nothing else really seems to be wrong and I'm overall pretty healthy. Still have the mild RUQ pain that started this several years ago but everyone says to stop worrying about it.
My question: Could this still be cirrhosis? The only thing Red palms and itching together seem to match in any of the things I've read are cirrhosis and PV. I don't seem to have any of the other symptoms of either of those things however.
the list is long as far as how you can contract...not as easy as some think, but easier than many do.
I'll find the list for you.
my symptoms began with sweats/fatigue/ red blotchy palms, itchy sometimes...pain in rquad came later....by then I was stage 3/4.......meaning your liver is 3/4 shot.
get the right tests, don't fool around with this virus if you have it you need tx. come to the hep forum on this site anytime and read up.
see, getting the right tests instead of huh, that's odd....20 people looked at my hands..omly one knew it was classic liver disease....
also....telling you to "test microchondriaals" is like talking greek to a mongolian.
just get you ANTIBODIES tested, AND your VIRAL LOAD AND your Genotype (RNA>DNA) test.
simple english for us simple folk.
hope I'm wrong for your sake, but if not, you know where to find us now.....hepatitis forum in here.
I'll find the list for you.
my symptoms began with sweats/fatigue/ red blotchy palms, itchy sometimes...pain in rquad came later....by then I was stage 3/4.......meaning your liver is 3/4 shot.
get the right tests, don't fool around with this virus if you have it you need tx. come to the hep forum on this site anytime and read up.
see, getting the right tests instead of huh, that's odd....20 people looked at my hands..omly one knew it was classic liver disease....
also....telling you to "test microchondriaals" is like talking greek to a mongolian.
just get you ANTIBODIES tested, AND your VIRAL LOAD AND your Genotype (RNA>DNA) test.
simple english for us simple folk.
hope I'm wrong for your sake, but if not, you know where to find us now.....hepatitis forum in here.
Hi and thanks for your comments.
I have donated blood several times since 1990 when Hep C was added to the blood donation testing and every time the letter I've received afterward indicated all was fine with my blood. Also, wouldn't they have tested my blood for pathogens with all the blood work done before my surgery a couple of years back? I don't discount what you say as you've obviously had your own experience with Hep C. Just know that I would have had to have contracted it more than 25 years ago and have had many check ups and blood work and blood donations between now and then and nothing has ever shown up.
I have donated blood several times since 1990 when Hep C was added to the blood donation testing and every time the letter I've received afterward indicated all was fine with my blood. Also, wouldn't they have tested my blood for pathogens with all the blood work done before my surgery a couple of years back? I don't discount what you say as you've obviously had your own experience with Hep C. Just know that I would have had to have contracted it more than 25 years ago and have had many check ups and blood work and blood donations between now and then and nothing has ever shown up.
ps, since now there is a treatment that cures 50-90 percent of hep cases and save us from liver failure, not getting checked would be ludicrous.
hope that helps you.
MB
hope that helps you.
MB
glad to hear you are sober, we all need to come to that place!!
you have some classic symptoms of liver disease.
red palms and itching are common to the virus Hepatitis C, which is now the new epidemic in town.
my first suggestion would be to be tested for all forms of hepatitis.
my doctor was dismissive for yeears, and I got the " I don't know " also. they did same tests but NOT for the most common and obvious largest blood disease namely Hep.
alcohol could have caused fibrosis, which can be reversesd, with right diet and care, but not all cirrohsis can be reversed, and none of it can if you have a virus no one has tested you for that may be destroying your liver in a hurry. while some folks take 30-40 years to start feeling the pain and /or having symptoms, other have symptoms sooner, cheif among those are the ones who drink/drank and pot smokers. In these cases disease progresses 7 to 10 times more quickly.
.
the main thing, to make sure your days of alcohol/sx/drugs &rock and roll did't leave you with a virus that sleeps for decades and then eats up the liver.
Hep c is the most underdiagnosed and often overlooked possibility of all right now, many go years with silly or non definite tests when the right answer was in front of the docs the whole time.
Not trying to scare you.
the docs advice above is good to a point, you do need a biopsy to determine true extent of liver damage...NEITHER ultra sound or Cat scan may show up with anything even when in reality you are stage 3/4...very far along. this happened to me.
ATTENTION HERE, the fact that the trying to be helpful Dr. Kevin failed to mention you should test for HEP once again makes my point that the medical community doesn't always think this through or order the proper tests now doesn't it!!
I rest my case.
you have some classic symptoms of liver disease.
red palms and itching are common to the virus Hepatitis C, which is now the new epidemic in town.
my first suggestion would be to be tested for all forms of hepatitis.
my doctor was dismissive for yeears, and I got the " I don't know " also. they did same tests but NOT for the most common and obvious largest blood disease namely Hep.
alcohol could have caused fibrosis, which can be reversesd, with right diet and care, but not all cirrohsis can be reversed, and none of it can if you have a virus no one has tested you for that may be destroying your liver in a hurry. while some folks take 30-40 years to start feeling the pain and /or having symptoms, other have symptoms sooner, cheif among those are the ones who drink/drank and pot smokers. In these cases disease progresses 7 to 10 times more quickly.
.
the main thing, to make sure your days of alcohol/sx/drugs &rock and roll did't leave you with a virus that sleeps for decades and then eats up the liver.
Hep c is the most underdiagnosed and often overlooked possibility of all right now, many go years with silly or non definite tests when the right answer was in front of the docs the whole time.
Not trying to scare you.
the docs advice above is good to a point, you do need a biopsy to determine true extent of liver damage...NEITHER ultra sound or Cat scan may show up with anything even when in reality you are stage 3/4...very far along. this happened to me.
ATTENTION HERE, the fact that the trying to be helpful Dr. Kevin failed to mention you should test for HEP once again makes my point that the medical community doesn't always think this through or order the proper tests now doesn't it!!
I rest my case.
MEDICAL PROFESSIONAL
You clearly had an extensive workup.
The most definitive way to diagnose cirrhosis would be via a liver biopsy. However, if it is not suggested via the imaging studies you have had, the chances of this is lower.
Primary biliary cirrhosis can result in itching as well an elevated alkaline phosphatase level. Testing for the antimitochondrial antibody can be considered if this is suspected. A liver biopsy again would give a more definitive diagnosis.
If the tests continue to be non-revealing, I agree with the dermatology evaluation.
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.
www.kevinmd.com
The most definitive way to diagnose cirrhosis would be via a liver biopsy. However, if it is not suggested via the imaging studies you have had, the chances of this is lower.
Primary biliary cirrhosis can result in itching as well an elevated alkaline phosphatase level. Testing for the antimitochondrial antibody can be considered if this is suspected. A liver biopsy again would give a more definitive diagnosis.
If the tests continue to be non-revealing, I agree with the dermatology evaluation.
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.
www.kevinmd.com
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