Confused and Anxious Beyond: Questions about fatty liver and cirrhosis

Posted by chinup23 @chinup23, Dec 28, 2023

Hello, I apparently had severe fatty liver Jul 21 but unfortunately was not told šŸ™ I sadly continued to consume alcohol - more than I should which I so terribly regret now but am totally alcohol free now since then. In June of this year I presented with Ascites and went to my Doctor. She stated she thought I had cirrhosis, this floored me - I did drink to much but to go from fatty liver to Cirrhosis in under two years seems insane? I had a Fibroscan and it was 11.8 kPa on Jul 7th and then had another on Nov 1st that was a 9.0 kPa.

I am wondering if there is any chance that I do have Fibrosis 2/3 and that the enlarged liver or fibrosis caused the ascites versus cirrhosis? The timeline and the low liver stiffness do not make sense to me. My Doctor (GP) told me I do not have Portal Hypertension and that I am early Cirrhosis - how is that possible if I have ascites? I am waiting still for an appointment with the Hepatologist and likely will not get in until Feb-May timeframe and this is hard to absorb.
Does anyone have any information they can help me with - is there hope maybe this is not actually cirrhosis? My bloodwork all came in line after I quit consuming alcohol within 3 weeks for the most part and is now all apparently better than most healthy people according to my doctor. Please - any advice would be so greatly appreciated!! Thank you so much!

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You are on the right path. Seeing a hepatologist is definitely in your best interest. That doctor can give you the answers you are looking for. They will be able to tell you if you have cirrhosis Since you have stopped drinking, and your blood work has drastically improved, you are in a much better place health wise. Here is a website on ascites
https://my.clevelandclinic.org/health/diseases/14792-ascites
Wishing you the very best.

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I hope you can find help with your questions. My mom has been diagnosed with fatty liver. Sheā€™s never consumed alcohol, with the exception of tasting wine one time in her life. Sheā€™s been told to watch her diet and to avoid certain OTC pain meds, but not much else about it.

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@celia16

I hope you can find help with your questions. My mom has been diagnosed with fatty liver. Sheā€™s never consumed alcohol, with the exception of tasting wine one time in her life. Sheā€™s been told to watch her diet and to avoid certain OTC pain meds, but not much else about it.

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Mr Dr says we all have a little fatty liver - I am so sad they did not tell me this as all of this could have been avoided but you cannot change what happened. It is my fault ultimately but I would have made the lifestyle changes needed had I been told just like I did now...sad that one little piece of information that was in the Drs hands did not get relayed and now this is happening. I hope and pray with all my heart that somehow this can be healed.

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This was what the last Elastology (Fibroscan) said:
Liver: Hyperechoic liver fairly homogeneous, although there is mild contour irregularity at the subcapsular
areas of the liver which could be in keeping with underlying chronic hepatopathy such as early
cirrhotic/fibrotic change. Measures 15.3 cm in sagittal dimension. Normal echogenicity.
Median Elasticity: 9.0 kPa
IQR/Median: 13%
Median Speed: 1.73 m/

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Cirrhosis is not a disease. It is scar tissue in the liver resulting from disease or alcohol abuse. It sounds like you do have some scarring. If the doctor thinks you donā€™t have portal hypertension, what does she say is causing the ascites? I strongly recommend you see a GI doctor ASAP. He/she should do an upper GI to make sure you donā€™t also have esophageal varices (varicose veins in the esophagus) which are very dangerous if left untreated. Is there a transplant hospital near you? If so you can ask for an evaluation and you will likely get more comprehensive care than anywhere else you can go.

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I am on the waitlist for a hepatologist at our best location but she says with a 9 kPa and my bloodwork as good as it is (she says it is better than most healthy people) I can't have portal hypertension. I have had ultrasounds and an MRI and and exray of my esophogus and nothing so far shows anything that points to that..so confusing. My GP says it is not a sign of portal hypertension always but it is a sign of cirrhosis...everything I have read says otherwise. My Child Pugh is a 6 and I am unsure of my MELD as she has not retested my INR/AST/Creatinine since this first came about late June but my albumin is39 which is at the top end of the scale and my alt is 33 and platelets are 137 and climbing...it doesn't fit at all with portal hypertension from what I know?

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Are you taking your blood pressure daily? If you have portal hypertension it will be high.

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@chinup23

I am on the waitlist for a hepatologist at our best location but she says with a 9 kPa and my bloodwork as good as it is (she says it is better than most healthy people) I can't have portal hypertension. I have had ultrasounds and an MRI and and exray of my esophogus and nothing so far shows anything that points to that..so confusing. My GP says it is not a sign of portal hypertension always but it is a sign of cirrhosis...everything I have read says otherwise. My Child Pugh is a 6 and I am unsure of my MELD as she has not retested my INR/AST/Creatinine since this first came about late June but my albumin is39 which is at the top end of the scale and my alt is 33 and platelets are 137 and climbing...it doesn't fit at all with portal hypertension from what I know?

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I think many of the transplant patients on this forum can empathize with your fear and frustration. Hopefully you can see the hepatologist soon and get some answers. For the record, I had refractory ascites (ascites not treatable with diuretics) and many esophageal varices, but my labs and MELD score did not reflect how sick I really was. I donā€™t want to second guess your GP, but it does sound like a second opinion from a specialist is warranted.

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@parrot53

Are you taking your blood pressure daily? If you have portal hypertension it will be high.

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yes I do and it varies from 106/70 P60 to today a little higher but not high at 112/79 P61..I am on Carvedilol.

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I am too. Your hepatologist will be most helpful. Donā€™t be surprised if you are asked about liver transplant. I was not prepared to be told I was a candidate for liver transplant. Long story short here I am three years later on the list but may soon be taken back off due to good liver function. This journey is different for everyone. You will likely be monitored from now on if you do have cirrhosis since people with cirrhosis are more likely to have liver cancer. I like your chin-up name. It means you hope to have a positive attitude which goes a long way when dealing with chronic illness. Hoping you have good news when you see your liver doc.

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