I posted recently expressing concerns about the health of my liver following an extended period of heavy drinking. I did experience some symptoms, be they real or imagined but regardless, the extent of my drinking coupled with knowledge that cirrhosis is often asymptomatic in its early stages has left me very worried. Thank you to those who responded to my previous post.
Following what were reported to me as normal results of blood tests and an ultrasound, I was nevertheless scheduled for an endoscopy and colonoscopy to explore the cause of possible blood in the stool. Both came back normal with the exception of intestinal hemorrhoids, which I was told were not serious. Also, I was specifically told that I do not have esophageal varices. At the time of these procedures, I showed what I thought might be a spider angioma on my chest to the gastroenterologist. Because it blanches (disappears briefly) when pressure is applied, he confirmed that it could indeed be a spider angioma, but insisted in spite of this that I have no signs of liver disease.
The gastro specialist could tell that I was very anxious to have reassurance and told me that even if there was undetectable damage, his advice would be the same: no further testing and abstain from drinking. Let me make myself clear that I take this advice very seriously; I don't believe that drinking is an option at this point; if I have undetected fibrosis even moderate drinking might be detrimental. I plan on a life of abstinence from alcohol and am utterly committed to this plan.
What worries me is that many seemingly valid sources point to blood tests and ultrasound results as unreliable. I realize that I cannot have absolute certainty and must accept the unknown, however I want to be somewhat prepared for what may be in store in years to come in the case that I have compensated cirrhosis.
I know that many post on this site looking relief to health anxiety, and I apologize if it is an annoyance, however I also know that there are some very knowledgable contributors here and I value your input regarding my situation. Again I emphasize my commitment to sobriety even if further testing confirms a healthy liver; the anxiety just isn't worth it.
If I were to sum up my question concisely it would be: With normal blood test and ultrasound results and no signs of decompensated cirrhosis (no varices, etc.,) and given complete abstinence, what is the worst case scenario within reason?
Thank You,
Cedric
P.S. I cannot provide that actual results of the tests I received.
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ceddietom
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Without test results it's hard to determine. While normal lab results are no guarantee of liver health , they are a good indicator because a complete liver panel test for recent damage and liver protein synthesis( basically liver function). Since your other tests all came back negative, in all probability you are fine. At worst you could have mild fibrosis and if this fibrosis is recent then it may dissolve to a degree with abstinence. All tests for cirrhosis are not guarantee if liver Heath if they come back negative. There may be mild fibrosis.The fact that you have no variced is a good indicator that blood flow through your liver is good which wouldn't happen if you had a compromised scarred liver. All in all I would say you don't have much to worry about and with abstinence your liver will recover to as close as prime can be. You never had a fibroscan ? You can get a copy of your blood work from the doctor. It is your right . A look at your AST and its ratio to ALT is a good indicator of recent damage. Albumin, bilirubin and INR are excellent indicators on how your liver is functioning.GGT, ALP and platelet count all together tell a story. If you can get the results share them with me and I can be more accurate. I have read extensively for 5 yrs on the subject and fell I know quite a bit. I too was very scared and still am. Liver disease is very serious as it tends to be progressive over time. The spider angioma is a bit concerning but the other tests don't back it up at all. I say you have little to worry about, especially being alcohol free.
Thank you for your thorough reply. I am going to look into obtaining my results.
OK Ced
I have checked your other post and to be honest it usually takes more than a couple of years to get to end stage Liver disease from booze .
Also its NOT common for compensated Cirrhosis go unnoticed by doctors if they are specifically looking for Liver damage, you will fine a few horrific cases by Dr.Google where things go undetected no matter what, but its rare.
I was afraid like you and I had the same thoughts, I figured I would be atleast compensated, but I still didnt like the idea of slowly reaching the end stage. I went for a FIbroscan and it was 4.2kpa, no where near Cirrhosis.
The last two years were only the worst, with the very last year being sometimes a fifth a day. I'm certainly not proud of this, and feel particularly ashamed when reading of those suffering through no fault of their own.
Thank you for your reply. If I may ask, where did you read/hear that it is not common for compensated cirrhosis to go unnoticed?
I drank for 20 years, usually a couple of times a week, about 30-40 units average I would say, not crazy amounts, but too much for 20 years.
I have been following others stories on several boards and I have read alot of proper scientific papers on the matter. The normal route to Alcoholic Cirrhosis is around 10-15 "pint years" that is a pint of vodka every day for 10 or 15 years will give you a good chance of getting Cirrhosis, but again its still only about 20%. Another one that springs to mind was a study of Skid Row alcoholics who had 20 years of daily drinking under their belts, after testing they found only 6% with serious Liver damage.
The truth is whilst there are an unlucky few that can get Cirrhosis on half a bottle of wine a day, its usually very difficult to get Cirrhosis from booze if you have no other health issues etc.
I have heard off a Liver doctor that 95% of the time bloods will show something out of place if the Liver has serious damage from Alcohol. Whilst it is harder with a stretch of sobriety because ALT and AST may go back to normal, Cirrhosis will show in other things, Platelets for instance is a good one sometimes.
Just think about your fear for a minute, Cirrhosis is a very serious and life threatening condition, compensated or de-compensated, it means the Liver is so badly damaged it cant repair itself properly. Your doctors have been looking for Liver damage, I dont think they would keep missing Cirrhosis, compensated or otherwise.
I have seen many bloods now from people with confirmed Cirrhosis, their bloods ARE NOT normal, the best bloods I have seen were nearly all normal, Platelets, ALT, Billi, Albumin all normal, the person had been sober for 3.5 years and still their ALP was showing as 284. SO you see, having text book bloods means you dont have cirrhosis or even Fibrosis most likely.
If you are still scared then get a Fibroscan, im willing to bet that its normal, google has scared you like it scared me, try and think logically.
Also Varices start forming when Fibrosis takes hold, the endoscopy would have shown them starting to form, they dont just pop up when the scarring reaches F4. Also an Ultrasound is NOT useless despite what google tells you, its actually about 85% accurate in ruling out F4 scarring. Ultrasound can miss, but it would be causes such as Hep-c , Alcohol Liver damage is about the easiest type to spot, you are reading information about other causes where sometimes tests miss.
Thank you for your very informative and hopeful reply. I read it soon after waking up and it put me in a very positive mood. I trust your experience. I suppose its best to move on with life as healthily as possible.
Cedric
I think your final paragraph almost answers your questions really. Your results suggest that you don't have liver disease but two things stand out: you need some reassurance that is some respects this community cannot give you, other than to say what you already know - that your liver results look good; your worst case scenario - being run over by a bus? living in the 21st century? watching back to back episodes on Netflix? There may be some merit is asking for a longer appointment with your GP and getting some more professional reassurance and possibly some psychological support if your anxiety is getting in the way of living.
One thing I can say with some assurance is "Stay dry"; it is certainly the best thing I did.
Perhaps you're right; I appreciate your frankness. I won't continue to ask for reassurance but I wanted to see if the endoscopy results would weigh in on what my situation looked like. Of course you nor anyone else here can provide me with a diagnosis but I was hoping for a more general assessment.
It seems to me that much of the information about liver disease is ambiguous and contradictory. You will find some sources that say ultrasound is reliable, some that say otherwise. I know that there are many here that have dealt personally with these questions for years and I thought they might be able to help there, not speak to my personal situation.
In any case I appreciate your response and your humor! At least the bus would be quick.
If you have normal blood tests it suggests that you have no liver problems to worry about at the moment.
Any damage you have done to your liver is not showing up. This means that there is a high probability that by giving up drinking your liver will be clear in approximately 6 months.
Fibrosis would have been flagged as would cirrhosis given the way they alter the liver and it's function.
To calm your nerves (which we all understand) give up drinking and get a scan done in 8 months time. However, following your nhs tests you may need to pay for a private scan. Also keep an eye on the British Liver Trust events, at some point there will be one you can get to. They are specialists who will be able to tell whether you have any damage YET. I capitalised that because continued drinking could well cause damage.
Try to relax ,easier said than done in know but you really don't need to stress about it.
Hello Cedric my feeling is that you are an intelligent and articulate man and more than able to research the answers to your questions
I think that maybe some emotional support is what you are looking for and this site will help because we all have a liver ( in your case potential ) situation to deal with
I would advise a second opinion and be guided by that and to access this site whenever you need some help and support
Alcohol will always make any situation worse so that might be the first thing to deal with and as well as this site you might consider AA or similar
There is a non-invasive test none as a fibroscan which measures the hardness of the liver caused by severe fibrosis it is safer than a biopsy. ask your specialist to have the test. The higher the number that the technician discovers relates directly to the stage of fibrosis on the index of staging from 0 to 4 . 4 is cirrhosis.
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Almost out of the woods?
So sorry - still worry - about the diagnosis - missing fibrosis
Hello everybody, I am hoping to get some insight about varices.
