Cirrhosis?

[bluekiteflier]

Hello, and thanks for your time.
I have alcohol induced hepatomegaly. USG says 17 cms liver (moderate hepatomegaly) and 11 mm of portal vein. Sonologist Doc says so far, good, but maintain it. But I am worried that I may have cirrhosis. My LFT are fine, except increasing values of PT (INR), which started from 12 seconds (INR=1) a few years back,  to now 17 seconds (INR=1.33). USG says NO FREE FLUID. USG also says Bowel Loops ++
Bowel movements are irregular. A few months back, I had slight sewlling on my legs after long hours in one position. But that dissappreared in 2 days.
I am 40, male and worried sick of cirrhosis. I have quit alcohol, and run 3 miles 3-4 times a week. Have healthy diet.
Could it be cirrhosis? Is it a good idea to go for a biopsy? I do not consult a liver specalist, but a very good GP. He says, stay off the booze and you will be fine. Sonologist also mentioned that if the protal vein (presently 11 mm) exceed 12 mm, possibility of blood vomits are there. How can I avoid this?
Request you views.

[bluekiteflier]

hello eureka and walrus,
hope you must have seen my post on my reports as well. The blood ammonia came out clean at 25. Also visited a hepatologist today. His observations:
1. I do not have hepatitis or any degenerative liver condition, just fatty liver by lifestyle issues.
2. All my blood tests are normal. Inr is not a issue presently.
3. Keep watching SGPT. Since that is normal, not much of a problem.
4. Reduce weight to get the targeted BMI of 25; which is presently 29.
He also added, enjoy life, but safely!

[bluekiteflier]

just a thought...my portal vein size six years ago was 10.8 mm, presently it is 11.0 mm. The sonologist is also a color doppler image guy.
To my request for a doppler image, he refused, saying 'not advised/needed'.
Also, 11 mm of portal vein is not a bad size, risk of upper gi bleeding due to varices is above 14 mm portal vein size, right?
The sonologist AND GP do not recommend even a further CT scan, leave alone a biopsy. I am going to consult a GI tommorow, and i think he is going to say the same.
Which is good, only that everytime i speak a little louder or have a sore throat, i feel i am going to vomit blood. Is it all in the head?

[eureka254]

My husband was terribly nervous before his biopsy, thought it sounded scary too, but after the procedure, he said he felt silly about being anxious over something that was "a piece of cake!"  Don't worry to much about the procedure... it's usually done under sedation, and you won't feel much or remember much... my husband's procedure was done in no time at all.  

Biopsy is the best method to rule out or rule in cirrhosis because imaging (sonograms or CT Scans) are not sensitive in detecting liver damage.  It can sometimes visualize frank cirrhosis, but mild cirrhosis often goes unnoticed.  

Swelling usually means water retention, so you might want to lay off the salt to prevent it from recurring until you find out exactly what's going on.  And good for you on reading up on the disease:  knowledge is power, and learning about your condition is the best first step to staying healthy.  Keep on plugging, and stay sober!

[bluekiteflier]

That is a typo error..

I am COMMITTED on having a biopsy, however scary it may be. I...

[bluekiteflier]

Thanks a lot, Eureka and IAmTheWalrus
I am not committed on having a biopsy, however scary it may be. I am praying it is not cirrhosis. For the symptoms, I dont really feel i ever had any serious or long term symptoms. The basic question I have : Is cirrhosis not noticable on sonographs to CT scans? I had a Sonographt twice a year, for almost 6 years now, it is mild hepatomegaly (mh). A CT scan once, and even that said mh.
Swelling in ankles was just for two days, only once is last ten years. (which dissappeared by itself).
Thanks for your wishes, though and it is not a wonder. After the reading I have done on the disease in past six months or so, I dont see the bottle; I see a diseased liver.

[IAmTheWalrus]

Kite Flyer,

Good advice from Eureka above. I just want to add congratulation on your sobriety as well! I think your regular doctor is emphasizing that staying off the alcohol is the best and most important factor in preserving your health. Without that, all else would be of little help.

It sounds like you are on the right path, though seeing a GI doc is also good advice. Keep it up and good luck to you.

Brent

[eureka254]

First of all, congratulations on your continued sobriety.  It will be essential in helping you keep your liver functioning well.  I do think the symptoms you mentioned: leg swelling, hepatomegaly on imaging, irregular bowel movements, and increasing INR may be good reason to have a biopsy if you have not had one recently. Perhaps you should ask your doctor if biopsy is an option if you have suspicions of cirrhosis.  It may be that it's time for you to seek a second opinion with a GI or hepatologist if your doctor and you are not in agreement.

Also, the statement from the sonologist about 'blood vomits' (called bleeding varices) would raise question of the possibility of cirrhosis and related portal hypertension -- if it happens that you are considered at risk for possible varices, your doctor can prescribe beta-blockers to lower the portal hypertension and avoid esophageal bleeding.  Have you had an endoscopy to check for any risk for bleeding?

My husband has cirrhosis and has been taking medication to help keep his portal hypertension under control, and staying active and eating healthy has helped him a great deal.  I will add, however, because of his liver condition he is recommended a low-fat, low-salt diet.  It's important to get adequate protein and fiber, but to stay away from red-meats, keeping to fish, beans, and nuts as the main sources of protein.  Hope that helps.