Advice

Any advice would be great , I have a history of alcohol problems not drank now for 6 mths my alt ast won't come down so having biopsy . I'm terrified x

[AyrshireK]

First off Goddard, welcome to the forum and congratulations on your 6 months sobriety.

As you acknowledge you've had a history of drink problems so your liver has no doubt taken a bit of a battering and 6 months is no time at all on the journey to recovery, this is going to have to be a total lifestyle change - no booze again ever.

I am not an expert on alcohol related liver disease but your liver goes through various stages of damage if continually assaulted by toxins - high ALT would point to an inflamed liver. The liver gradually gets more and more fibrous and eventually may scar leading to cirrhosis of the liver - the earlier stages of damage are somewhat reversible (the liver can repair itself when the causal factor is removed) and even minor cirrhosis can be improved however a full blown cirrhotic liver means that part of the liver is in effect dead and none functioning. The liver is an amazing organ doing more than 500 different jobs. When some of it isn't working then it reduces which of these functions it carries out, it compensates by doing only what it needs to and this then potentially causes other side effects.

A biopsy will give some sort of idea of what stage your liver is at and even possibly the cause of your issues because even though you have drink issues the liver could have been damaged via other means and it isn't unusual for different liver conditions to be going on at the same time.

The procedure itself if pretty straight forward, my hubby has had two - one through his side which was just with some local anaesthetic - they put a needle in to the liver and draw out some tissue. You then have to lie down still for some hours and be closely monitored to ensure no internal bleeding etc. Relatively pain free and without trouble. His second was a transjugular one, he had a little bit of sedation for that and a local anaesthetic and the sample was taken via a needle passed down through the various veins of the body from the jugular at the neck. He only had a minor twinge in his right shoulder as the sample was drawn but other than that all went well and it was generally a pain free experience - again he had to remain still for several hours afterwards and had an overnight stay in hospital for monitoring. Take a book or music or something to while away the hours.

Hopefully after your biopsy doctors will give you some indication of where you go from here. Maintain your sobriety and you'll give your liver the best chance.

All the best to you, Katie

[Hidden in reply to AyrshireK]

Thank you for your reply my ALT and Ast won't lower even without the alcohol so I'm finding it really hard to deal with .

I really appreciate your reply thank you x

[AyrshireK in reply to Hidden]

It might just require more time, as I said you are just at the start of your journey.

However, the biopsy might throw light on what else is going on. Perhaps as I said there is another causal factor and it isn't unusual for the liver to have more going on than just alcohol induced damage. Stay the course, stay off the booze and give your liver a chance, even if your issues arn't to do with the alcohol it won't have helped matters if there is some other underlying condition.

Alcohol isn't the only thing which causes liver inflammation, it can be viral conditions, auto-immune conditions, genetic/inherited conditions and lots more.

Fingers crossed the biopsy will shed a better light on what is going on and let you progress to some treatment options. All is not lost.

All the best, Katie x

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Thank you x x

[Hidden]

Goddard1 When you stop alcohol the inflammation should stop. Do you have the numbers? are they trending down?

I have seen many sets of bloods regarding Alcohol and even when someone has advanced cirrhosis the ALT and AST drop to normal or near normal pretty quickly once the alcohol is removed, sometimes just the AST hovers above normal. 6months should be plenty of time for the affects to settle. Even a case of severe alcoholic hepatitis(you be in ICU) should show normal bloods on the 6 months mark.

I think they maybe another factor involved here, iron storage or viral hepatitis.

have you have any ultrasounds or CT scans?

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Hi alt 106 ast 80 x

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Very worrying feel pretty rubbish but know what you mean re numbers dropping .

Had ct and ultrasound normal x

[Hidden in reply to Hidden]

it good the scans are normal, cirrhosis is unlikely to be missed with them. Dont forget cirrhosis is the end stage of the disease process, early damage could still be starting, but even fibrosis should show something on those scans.

The biopsy is likely to have an exploration angle to it, at the moment it seems they dont really know whats going on.

hopefully they can get some answers and stop this inflammation, it is the enemy of the Liver and will lead to issues at some point if its not stopped.

Have you have auto immune tests and Hep c,b,e etc?

[Hidden in reply to Hidden]

Thanks for replying yes I've had them all . Just constantly feel rubbish too but it's definitely made me wonder re the no alcohol why hasn't it gone down .

I was worried I wasn't going to be belived re no drink but the only person I would could would be me and i wouldn't do that.

My ggt is normal

[Hidden in reply to Hidden]

Would fool that should read

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GGT is found in the bile ducts and elevates in most drinkers and also when the Liver becomes fatty. having that low is a good sign the damage isnt from alcohol.

how much drink are we talking about here?

the worst out come would be "cryptogenic" , where they basically say they dont know the cause.

[Hidden in reply to Hidden]

Off and on for about 6 years but did it as I was so depressed self medicated myself .

I will just gave to wait and see but like you say even people with chronic ciroshis their numbers go down .

Have s terrible bad back and I ache no appetite feel like I can't breathe wheezy chest but not sure how much is stress

[AyrshireK]

Now that you have mentioned wheezing and difficulty breathing (and your alcohol misuse isn't of that long a duration) - all clear ultrasound etc. it sounds like something else is definitely the root cause of your issues.

Do you know if doctors have tested for Alpha 1-antitrypsin deficiency? - I am no expert on this but there is a regular poster who's partner had it leading to transplant (don't panic with an all clear ultrasound you arn't nearing that stage).

The reason I ask is that this condition affects both the lungs and the liver and is to do with a certain protein deficiency in the liver. Just a thought and might be worth a further blood test or two just to rule this in or out.

Katie

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Thank you I will ask . I thought with ciroshis fluid built up on the lungs it's not exactly wheezing I feel as tho in drowning when I lie down .

Also my legs ache just generally feel as touch I've always got flu x

And my liver burns also terrible indigestion x

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I always hot too

[AyrshireK]

If your ultrasound was clear then you almost certainly don't have cirrhosis as it shows up on ultrasound. Fluid build up/ascites (which can indeed affect breathing) is a late stage effect of cirrhosis and by the time that occurs the liver is very damaged which evidently yours isn't as it is not showing on scans.

Have you had an endoscopy (camera down your gullet)? Some of your symptoms sound gastric related.

As Ralph said earlier your doctors are going to have to run quite a few more tests, the biopsy just being one of them to help get to the bottom of what is going on.

Wish you all the best and fingers crossed you get some answers soon.

Katie

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I had ultrasound a year ago and ct last month.

Endoscopy too but that was more looking I think for indegestion problems .

I'm hoping ct looks for ciroshis too.

Many thanks for your help really appreciate it x

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You have really helped me thank you x