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Forum Name: Liver Diseases

Question: Liver Worry


 AndyH8 - Fri Feb 16, 2007 9:24 am

Hi.
I have had losse stools for seven years now and during that time drunk to much alcohol from stress and anxiety because of health worries. I had all sorts of unexplained joint pain and burning urine, feeling spaced out. Very worrying. All blood work apart from liver was normal, CBC, ESR, CRP etc. Tested for diabetes normal.
My liver enzymes have been elevated ALT and AST 140 for this time and vary. My GGT has been 500-700 at times. My albumin, bilirubin are and all other tests I am told are normal. HAd tests for Hep ABC all negative.This all started on 2000. I abstained form alcohol for 6 weeks in 2001 and my readings didn't change. So had a liver biopsy which revealed a mildly fatty liver not enlarged and no damage. So Doc's said moderate alcohol lose weight and exercise. So I did but continued to drink socially. I also took milk thistle which helps keep the readings down to 90 ish. My urine is sometimes darker than normal but contains no bile.
I went back in 2003 after my stools and joint pain didn't resolve.
Been for endoscopies both ends, had rheumatology tests, brain scan et al. All nothing showing. So they did another biopsy which showed a fatty liver again with no reason for the symptoms I was experiencing. The moderated alcohol seemed to be making no difference. So they said just stay the same. So I drank socially maybe a glass of wine or two 2 or 3 times a week. Or occasionally more at the weekends.
My stools are still pale and seem greasy and I have checked the internet for liver symptoms which scare me to death.
I do have Terry type nails not white but distal band redness white deposits in the nail. My eyes are somewhat blurry and I do have tenderness in the right upper quad and back stiffness particularly in the morning but my doc thinks I am a hypochondriac. Drank a little more over the last year due to depression and no real answers in sight but this makes things worse and I begin to worry if this is harming me more so I have now stopped for over five weeks but no improvement as yet. I don't know where to go next but do wonder about my liver. If its just fatty liver with diet and exercise will this resolve? Should I do a liver flush to help release the fat. Not sure what to do next. Any ideas please.
 Dr. Wafaa Abdel-Hadi - Sun Feb 18, 2007 8:08 am

Dear AndyH8,

I am very proud of you for decreasing and trying to stop alcohol consumption,this is very important once you start to have liver problems, especially fatty liver.

I am concerned about the GGT tests...it indicates that you do have something wrong in your biliary system...
and to have pale loose stools, that indicates that you have a problem in fat digestion, which supports the idea of a biliary problems +/- a pancreatic problem.

What needs to be done now is to discuss doing a CT scan of the abdomen and pelvis with contrast with your doctor... instead of doing an ordinary abdominal ultrasound and then do a CT scan...so we'd be able to view liver , its biliary tree, gall bladder,pancreas and any enlarged lymph nodes pressing on the common bile duct leading to malabsorption of fats.

I need you to check your bilirubin levels for me in your previous lab tests...the direct and indirect ones.
then after the CT scan results, get back to me and we can think up a list of possible causes, ok?

Best regards,
 AndyH8 - Sun Feb 18, 2007 4:21 pm

Ok.

Will talk to the doc next time I am there. Not sure he will want to do the test but I will try.
In the meantime my total bilirubin was 13 umol/L and my direct bilirubin was 2 umol/L. Also for reference albumin was 47 G/L, Globulin 25 G/L. ALT 145 U/L, AST 86 U/L, GGT 587 U/L.
Always assumed that my drinking caused this especially the GGT.
Should I continue with the milk thistle or is this giving me false readings. Was fearful of stopping if this was helping in the light of no further help from the docs.

Many thanks.
Andy
 Dr. Wafaa Abdel-Hadi - Sun Feb 18, 2007 6:19 pm

Dear AndyH8,

All your liver functions are absolutely fine apart from the ALT and AST ofcourse...you can continue use the milk thistle.. it is a herbal extract , safe to use and is very beneficial in liver diseases.Its active ingredient is called Sylimarin and it is an anti-oxidant that protects the body and thus regenerating cells in a better enviroment.

As for the GGT?! well, you can also ask your doctor if he approves on adding dandelion root extract to the milk thistle.. it is a herb as well, liver tonic,mild laxative and very good for the biliary system.

Best regards,

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