Does NAFLD cause pain??

[scotslass333]

Hi everyone, I've dipped in and out of this forum for the last few weeks but not really explained my whole story. Been getting pain (quite sharp) in right side of abdoben, off and on, not constant or severe, just worrying. A scan last year showed some fat in liver but told nothing to worry about. I am overweight by a stone, but equally I have lost a good bit too. I don't drink alcohol. I have seronegative rheumatoid arthritis which means inflammation. Not on any strong drugs for that at present. Have had slightly raised blood test liver levels a couple of times, no idea which ones sorry. But always told "your liver's fine" after any blood tests and last ultrasound a couple of months ago. I had my iron level checked 2 weeks ago, as usual told "it's fine"!! So I suppose I'm looking at either NAFLD, or something else entirely is causing the pain?? Can anyone tell me if you do get pain from having NAFLD? Or if it had progressed to NASH, would that have been clear from blood tests anyway? Just not sure whether to ask for more tests, or just accept its only a niggle and try to lose more weight. Oh and I take a lot of antidepressants at a high dose, for many years now, and I know they're not good for liver/other organs. Pain I get is slightly below where I think my liver probably is - maybe it's colon?? Grateful for any thoughts. S.

[AyrshireK]

I think I would be tempted to request some follow up to look at your liver. Whilst doctors will say the liver doesn't get sore, people who are experiencing liver inflammation do experience pain and it is when the sack surrounding the liver gets stretched that this pain occurs. You've said a few things in your post which although don't ring alarm bells do pose some questions.

Ok fat in the liver isn't something to be fobbed off with and not worry about - fat deposits in the liver can over time lead to damage to liver cells, fibrosis and then scarring. NAFLD is reversible and great stuff that you've lost some weight, keep doing what you are doing on that score because being as fit and active as possible and eating sensibly will all help that (reduced salt, fat, sugar and processed foods).

Obviously all tablets need to be processed by the liver so there is a risk that they could lead to bits of liver damage.

You have Rheumatoid Arthritis which is an auto-immune condition and it is not uncommon for people with one auto-immune condition to have others. Auto-Immune Hepatitis might be something they could look into for you as it too can 'flare' and cause episodes of liver distress & untreated over time can lead to liver damage.

Don't be fobbed off, it is your body and you know that something isn't normal or right for you so request some follow up.

Wishing you the very best of luck, Katie

[scotslass333 in reply to AyrshireK]

Thanks a lot Katie, really good advice - will try to be more assertive with GP. It is always there at the back of my mind, "what's causing this pain??". Yes, autoimmune hepatitis had occurred to me too, but reckon if I had that, it'd be unmissable? Anyway much appreciated.

[AyrshireK in reply to scotslass333]

They'd need to run some more tests to give a definitive AIH diagnosis - normally involves various blood tests for certain anti-bodies, plus liver biopsy and a response to steroids.

My hubby never knew he anything wrong with his liver until wham, massive variceal bleed and diagnosis of cirrhosis due to AIH.

Definitely push for any tests you feel you need and get a referral to a gastroenterologist (at least) a hepatologist (even better).

Katie

[scotslass333 in reply to AyrshireK]

Still trying to get my head around this - I had assumed that the u/scan showed ANY liver-related problem. Obviously not? Can I ask what caused your hubby's AIH, did he have RA or some other autoimmune disease first? If that's too personal, please don't feel you have to answer, I'll understand. I doubt that my GP would accept that I have sufficient pain to refer me to anyone - he was reluctant to let me have another ultrasound, had to get my Rheumy to refer me for that, pretty sure they have"Hypochondriac" on my notes. Which I don't actually blame them for, since I do have anxiety issues as well. But I am a little concerned that they just might be missing something. If only all my symptoms weren't so vague! No rush to answer this. Thanks again for caring enough to help. S.

[AyrshireK in reply to scotslass333]

No idea what caused hubbies AIH, no other auto-immune illnesses, no other previous ill health - did have a lengthy spell on an anti-biotic for acne but no one has ever been able to say anything more about his 'trigger'. They said his has 'burned out' i.e. he's had AIH, it's done its damage then stopped - he doesn't currently have active AIH just the cirrhosis it has left behind. (His is a weird presentation).

[briccolone in reply to scotslass333]

hi there lassie...U/sound is a helpful tool but doesnt show everything. I had fatty liver which didnt show on the U/s until it reached a certain level. At that point I had a fibroscan which was 7.2 I definitely had pain and other symptoms as well-digestive mainly. Mine were alcohol realted. Fatty liver whatever the cause responds well to diet change and exercise-not always but it seems to help. Sugar and alcohol big enemies of the liver.

keep posting

[Jeannieb12]

I have NAFLD and I have/had pain under my ribs on the right. I had pain before I had blood tests but my GP pretty much dismissed it. I have been told I do not have fibrosis but I've never been offered a fibroscan just an ultrasound. It sounds like you have a lot going on and I think it would be entirely reasonable to ask for a fuller evaluation. At least it will ease your worries and if anything shows up you can deal with it. Best wishes to you. Jx