Scared and lost, I think I have Cirrhosis, go to the emergency room? what to do?

[medhelpuser343]

Hi,

I've been having problems for two years.  The symptoms started with pain in my lower right back side and constipation.  At that point doctors said there was nothing wrong other than IBS (at the time they did blood tests, and sonigram and said everything was normal).

More recently I've had sever acid reflux, constipation, right shoulder pain, and right front abdomenal pain.  I went to a gastroentonoligist who did an upper GI and colonoscopy.  The upper GI showed gastritis, and I was told to take a PPI.

About a month ago I had an "attack" where I was nauseous, light headed, numb all over, and my tongue had turned yellow and I went to the emergency room (I waited a day before going, by the time I went my tongue was no longer yellow).  They did a sonigram and blood tests.  Blood tests showed slightly elevated billirubin (2.2) and slightly lower lymphocyte.  Sonigram showed beginnings of "sludge" in my Gallbladder.  The report also mentioned a liver lesion but the doctor did not mention it, and the pancreas "was not seen".  The doctors at the emergency room said it was nothing more than gastritis, and I should eat better.

Now I am itchy all the time, have a red rash all over, continuted severve constipation and GERD, and the yellow tongue comes and go.  I was a heavy alcohol drinker (have stopped drinking since a month ago).  Some other things - I am fairly certain that I've seen Gallstones in my stool (blue fuzzy things), I constantly see black spots in my stool, the right side of my stomache sticks out slightly more than the left, and I've had left calf pain for a few weeks that seems like a sore muscle but I've done nothing to cause it.

I am convinced this is cirrhosis because of the itchy skin, yellow tongue, elevated bilirubin and alcohol abuse, but I don't know what to do.  I'm tired of doctors acting like I'm crazy and telling me it's an upset stomache.

If I make another doctors appointment, it will take two weeks to see them, and another two weeks to get the labs done that they order.  Should I go to the emergency room again?  Could I have Pancreatitis?  Could things be getting worse by not getting timely treatment?  I feel like doctors will only take me seriously once I'm dead.  What type of doctor should I see?

Thanks for any advice you can provide.

[CalGal]

I think you may have misunderstood a couple things I said, or I may not have stated them correctly. I know you said you were the heavy drinker. I assumed you must have told both the ER personnel and the doc you went to that fact in order to give them all the facts. Docs would not feel they could change your lifestyle, but with the symptoms you are worried about - which may be or can be tied in with alcohol - most docs would suggest you discontinue drinking and watch your diet.

Their diagnosis would not change in any manner whether they told you that or not. They would make their diagnosis based upon your symptoms.

If a doc in the ER feels that someone is coming in with a life-threatening illness, that person will immediately be admitted and a further work-up will be done. Evidently in your case they did not feel that your symptoms suggested that your immediate symptoms were extremely serious, despite the way you felt. And if you were jaundiced, the docs evidently did not physically see that. When that happens, they refer the patient back to their physician for follow-up.

I know you've said you're tired of docs acting like you're crazy, we all are. But why didn't you follow-up with your own doc or find another doc you can work with right after being at the ER? If what is going on is cirrhosis, the only one who is going to be able to help will be a doc.

There are several stages of cirrhosis, and yes, it can be life-threating. But not all cases are. And you won't have any idea whether or not you do have cirrhosis unless you find a doc to work with and sort out the symptoms you're having. Some of the symptoms you're relating can also be found in other conditions such as gallbladder dysfunction.

[jamespinaa]

If you had Cirrhosis, you would have known way before any symptoms.  Try to relax.

[ggreg]

Dear Med,
That itching skin can sometimes mean something is wrong with the kidneys, which I think the yellow also indicates same thing.  A urine sample will detect any problem with that.  I don't think a kidney problem is life-threatening.  The kidneys are located at the back of the body, on either side of the spine, at the level of the waist, so could be the lower right back and right shoulder pain you felt was coming from the right kidney.

But you also said the sonogram suggested a sluggish gall bladder.  It's located higher up, in the front of the body, to the right of center.  That might also account for your pale stool, which comes from changes in bile, which the bile ducts are next to the gall bladder.  Again, a goofed-up gall bladder or bile ducts probably won't kill you.

My suggestion is, if your tongue goes yellow and/or you feel pain again, and especially if you have a temperature, you can go to the ER, tell them about the itchy skin, yellow tongue, pale stool, and the pain in your lower back on the right and in your shoulder on the right, and the sonogram that said you had a sluggish gall bladder.  They ought to go ahead and do a scan, which doesn't pick up everything, but is better than the sono for some stuff, and they ought to do a urine sample, which their lab will have the results immediately.

I also think you could just wait for the doctor appointment, and in the meantime, drink a lot of water, five or six glasses a day, to flush the kidneys.  Water also helps constipation (alcohol dries you out).  And just eat soft or bland foods, like rice, wheat bread, apple sauce, mashed potatoes, but don't eat heavy stuff like steak or french fries.  You could also eat "Activia" yogurt, which has "good" bacteria in it to help break down waste.  Also, a natural disinfectant for the bowels is pineapple, just don't consume that with anything else, and just eat a small bowl one time.

It takes a long time for the liver to give out, unless you've been drinking steady for twenty years.  This is just general info, I'm no expert, I'm just telling you the little I know.
GG

[medhelpuser343]

Thanks for the response CalGal, but I need to clarify somethings - the doctors never said I was a heavy drinker, I said that, they never told me to quite drinking, that was my decision, and I seriously doubt whether they felt they could change my lifestyle would affect their diagnosis, as that'd be malpractice.

>  They're really not there to diagnose anything unless you're in a state of emergency or in an immediate life-threatening condition which your symptoms do not seem to suggest.

What are you basing this on?  Being jaundiced is not life-threatning?  My understanding is that if I have Cirrhosis that there's a good chance I'm going to die.  Is that not correct?

[CalGal]

If you've been having problems for two years and have gone to the ER and a doctor, had tests done that may have shown changes in liver function, if you told the doc you were a heavy drinker but did not change your drinking habits until a month agao, it's possible that the docs may have felt they could do little until you made changes in your lifestyle. If you're serious about trying to take care of your health and you intend to discontinue alcohol intake, go back to your doc and discuss the problem openly.

It may or may not be cirrhosis, but the only way to figure it out and figure out what to do about the current symptoms is to be seen and figure out what your next steps will be. This should be done by your private physician, since the ER will probably simply do a CBC, give you some PPIs or other meds to tamp down the symptoms, tell you to see your doc and escort you to the door. They're really not there to diagnose anything unless you're in a state of emergency or in an immediate life-threatening condition which your symptoms do not seem to suggest.

The doctor to see would probably be a gastroenterologist.

[medhelpuser343]

And the itchyness happens mostly after eating or drinking (non-alcoholic stuff, including water)

[medhelpuser343]

Also I've been having pale stools off and on for 6 months.