Looking for some help

[zandre]

In early September of this year I got Mono however I didn't go to a doctor to see whether or not it was Mono until about 2-3 weeks into the illness. During that time period I was drinking alcohol, which I discovered was a huge no-no. I had a year straight out of hell. My Grandfather died, parents seperated, had to withdraw for a semester in college because of the Mono and I handled the situation completely wrong and began self-medicating like a retard.  I felt like the biggest loser around that I let myself do that.  When I finally went to my doctor he ran a blood test confirmed I had Mono. About 2 months ago I noticed ankle swelling and went immediately to my Doctor because I had no idea what it could be.

I was frank with him about my drinking but he still felt I was likely alright. He ran several tests one of them being a LFT. At that time I was still drinking and results were ALT was 90 (avg. 0-60), AST 53 (avg. 13-38) My Bilirubin and Albumin were both in the average ranges. There was no evidence of a Prothombine mutation. He also ran a Hepatitis test as well that came back negative. He attributed the raised ALT and AST to the drinking and Mono still lingering as he could not feel any inflamtion in my liver. I've completely quit drinking for about 5 weeks now. After I stopped the drinking I had another test about a week and a half ago (3 weeks out from drinking) and the tests came back within normal ranges as follows:

ALT: 57 IU/L
AST: 26 IU/L
Bilirubin: 1.0 MG/DL
Albumin 4.5 GM/DL

My Doctor does not believe there is anything wrong.  However I'm just not so sure.  If you need any other information please let me know.  I hope I'm just paraniod but I'm just very nervous.  If you need anymore information to help answer the question please let me know.

[zandre]

My doctor also said he couldn't feel my liver and my abdomin is not tender. However during hot showers I notice a stomach throbbing (much like a heartbeat) right in the center of my abdomin. Which has also been less noticeable since stopping the drinking but still occurs. My doctor thinks its just an abdominal spasm and told me to start taking metumusil. He told me there were prescriptions for it but didn't want to take that route just yet because he didn't want me on any drugs which I completely agreed with. The ankle swelling has gone down quite a bit and it just about to back to normal. With those last results do you think there is any possibility I have any kind of liver disease? I trust my doctor but getting a second opinion definitely helps my anxiety.

[FurballsMom]

I think taking the fiber supplement is correct, because this sounds like the colon spasming.  There is a gentler fiber that I have found to be less irritating to the gut.  This is flaxseed meal.  I read of a woman who said that she used it much like one uses Metamucil and drinks it down first thing in the morning and last thing at night and has done so for years.  Taking psyllium fiber (the main ingredient in Metamucil) wasn't helpful for her bowel troubles, but the flaxseed meal was.  I find it helpful for me, too, but I simply add it directly to whatever I'm eating.  It doesn't matter how it is ingested, as long as it works for you.  I think the flaxseed meal is just easier on the body's system.  And, it's something that is added to many baked goods.  You can explore other ways of adding it to your diet, so that it's actually enjoyable to eat.  My friend adds it to her homemade salad dressing as a thickener and binder.  It works well.

I can't comment on the liver issue, though.  I don't know enough to say much of anything.  Sorry, but I can't help in that regard.  I only know that flaxseed meal is gentler on the digestive tract than psyllium fiber is.

[Kevin Pho, MD]

The liver function tests are mildly elevated - and this can be seen with alcohol consumption and as the result of side effects from medications.

To ensure there isn't anything else going on, I would suggest blood tests to exclude viral hepatitis.  An ultrasound of the liver can also be obtained to exclude anatomical disease or fatty liver.

If the tests remain negative, serial monitoring of the liver enzymes should be considered to ensure they aren't going up.

These options can be discussed with your personal physician.

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 Pho, M.D.
KevinMD.com