I went to A&E yesterday with severe pain for the second time in two months. Diagnosed with acute recurring hepatitis

[sergregor868]

Hi all,

I just wanted to post an update on my previous posts. I went to hospital on Wednesday as an outpatient where I had an endoscopy done. This was arranged by the consultant I saw in November after going to A&E in October, when I had very high LFT results. I decided to have the throat spray without sedation. It was very, very unpleasant. I was diagnosed with Barrett's Oesophagus. It was only a small 1cm segment but still very worrying. The consultant took 8 biopsies from my lower esophagus and stomach. I haven't had the biopsy results but if dysplasia is found I will need treatment as soon as possible to stop it developing into cancer. It also requires regular endoscopies to monitor the Barrett's. The nurse said it would every 3 years but I read online that it should be every 3-6 months if there is dysplasia. thought that was traumatic enough, but on Thursday night I had a recurrence of the severe abdominal pain that originally caused me to go to A and E. The pain was severe and worse than the last time. I went to A&E at 5.30 am and was in there until 4.30pm. During this time I saw 2 doctors and a consultant. I had blood test done in A&E which showed my LFTs were high again. My LFTs were high in October, went back to normal in November but were now high again. The first two doctors seemed not to know what was causing it, but the second said it might be hepatitis. I eventually saw a consultant. He said he wasn't certain what was causing my high LFTs but he said it might be drug-induced hepatitis from the omeprazole which I started taking a month ago. He said he has seen it cause liver inflammation in a small number of patients. He has switched me to Ranitidine and also prescribed 30mg codeine for the pain. I was given another appointment for Tuesday where I am having a liver ultrasound and more blood tests. He said if I still have high LFTs I would be urgently referred to a liver specialist.

I am hoping it doesn't get worse over the weekend as I don't want to end up in A&E again. Also I had orange urine when I was in A&E and also vomited once in the toilet. I've never had orange urine before. I read that can be a sign of liver problems. It seems to be going back to normal now though. Feeling a bit crestfallen as I haven't had major health problems until recently. I've had 2 A&E visits and 2 outpatient visits in the last 2 months, with another one next week. I will likely be having more in the future. I have a few questions about the hepatitis. What options are there for treating it? Is having a liver transplant the only cure? Also I am not sure what caused my LFTs to be high the first time (before I started the omeprazole). I have always assumed that hepatitis usually arises from unprotected sex, sharing needles and having blood transfusions. I haven't done any of that, and I also don't drink alcohol, so I am not sure how I've acquired it.

[Jahida]

Hello there,

Have you ever had liver problems in the past? I am not sure of omeprazole could cause liver damage. I was on omeprazole for years and when I ended up with acute liver failure, they ruled out omeprazole. I really believe you should be seeing a hepatologist at this point. They will know what tests to carry out. The urine being orange is part of liver issues. Are you yellow by any chance? Can you notice yellow skin? Also are the whites of your eyes yellow? There is a chance you have jaundice. I had very dark orange urine and I had no clue my liver was failing. Vomiting can also be part of it because the liver isn't working so well in helping digest the food and so it causes nausea and sickness.

If you are under a hepatologist then they will put you on many treatments and it is really what they feel is right for you. Usually they will try out steroids to see if they can bring the LFTs back to normal. They need to get to the bottom of why your LFTs are so high and you need a diagnosis. There is so many types of hepatitis and not just one type. Also it doesn't always have to be hepatitis causing liver problems. Like you mentioned it could be medicines or a viral infection. Sometimes it could be nothing...which was in my case. I suddenly fell ill and ended up with an urgent transplant.

You need to tell them to stop wasting time and refer you to the correct professional who will know what tests and treatments you need. Transplant is usually the last resort after they have tried many medicines.

Good luck. Try to get help soon though.

Take care

[AyrshireK]

Hepatitis just means liver inflammation. NHS has a page all about Heptitis and it's various factors at:- nhs.uk/conditions/Hepatitis...

There can be numerous causes of liver inflammation including VIRAL HEPATITIS which comes in numerous types A, B, C, D, E.

Hep A and Hep E are usually short lived tummy bug type ones which can be picked up through poor hygiene especially if someone has prepared food with unwashed hands etc.

Hep B & C are usually blood/body fluid borne and as you say can be caught through the behaviours you mention together with blood transfusions or tattoos (pre-modern day precautions).

Hepatitis D often goes hand-in-hand with Hep B.

You can also get Auto-Immune attacks on the liver and this can lead to AUTO-IMMUNE HEPATITIS (AIH).

Also, toxins can affect the liver causing heptitis (remember hepatitis just means inflammation of the liver) so ALCOHOLIC HEPATITIS can also come and go.

Your doctors will need to establish what is causing the inflammation in your liver so perhaps you will end up having a few more tests yet.

Once they have established what is going on then they can look at treatment options.

With Hep A & E it is usually short lived as I say and time heals - however if the infection has been very harsh on your liver it could lead to some liver tissue damage.

Hep B is treated by anti-viral medication - no cure YET but they can knock it down so that it is medication controlled.

Hep C can now be almost certainly eradicated and we are hearing great news stories on here all the time where Hep C has been cured and livers have been able to recover to some degree.

AIH takes a wee while to diagnose through various tests and often a trial of steroid treatment to see if LFT's respond positvely normally indicating it has been an auto-immune attack on the liver. Once identified it can then be somewhat controlled through the use of steroids followed by an immune suppressant (usually for life). Uncontrolled AIH can lead to fibrosis, cirrhosis and the need for transplant.

Alcoholic Hepatitis obviously doesn't apply in your case and so you won't need to make lifestyle changes on that score.

Docs will need to get to the bottom of it for you. I doubt it's your omeprazole if you had one of these 'attacks' prior to its prescription - Hubby been on it since April 2012 along with having cirrhosis due to AIH he has near normal LFT's and none of the symptoms you describe.

Hope you get some answers soon.

Katie

[Hidden in reply to AyrshireK]

Brilliant reply Katie. It saved me having to write anything since you covered all bases.

[AyrshireK in reply to Hidden]

Thank you, I do try.

Katie x

[grace111 in reply to AyrshireK]

you certainly do.

[sergregor868]

Thank you everyone. At the moment I am still experiencing pain. The codeine has been keeping it at bay but it didn't stop me being woken up earlier today by the pain. I also had pain yesterday immediately after drinking tea, which I have been drinking for years with no problems. I've lost my appetite and have barely eaten anything since Friday. I keep checking my eyes for signs of jaundice but that hasn't happened yet. My next hospital appointment is for tomorrow morning. I am having a liver ultrasound (which I haven't had before) and more tests. Should I be asking the doc to do a liver biopsy or will they most likely want to do one without me asking for it?

[AyrshireK in reply to sergregor868]

You are very early in this diagnosis journey - the pain and the food/drink issues are more likely to be as a result of what's going on in your oesophagus rather than liver.

An ultrasound might give them some clue as to the current state of your liver and associated abdominal organs BUT they may well want to do a liver biopsy to look at your liver at a cellular level (this is definitely a normal test for AIH and the other auto-immune conditions).

More blood tests too will need to be done. I would be pressing for referral to a liver specialist - I guess you are already seeing a gastroenterologist with your oesophagus issues.

Don't be fobbed off with 'wait and see' type scenarios, ask for referral.

All the best to you.

Katie