Trying this again. Questions about Fatty Liver.

[artemiss2291]

Hello,

I'm basically new here. Been a member for a while, but had no real need to post..until now.

I have been diagnosed with a fatty liver. I had an abnormal LFT. ALT, AST and Alkaline Phosphatase where all "mildly" elavated. Had an Ultrasound, which was inconclusive...they couldn't see my liver clearly because of gas in my abdomen. Then I had a CT scan with contrast a couple of weeks later. At the time of the CT scan I had my liver enzymes checked again, and they were all normal. The CT scan showed "diffuse fatty infiltration" of the liver. That was all it said on the report. I have an appointment with a GI Dr in Dec. I want to find out the extent of damage in my liver. Was the CT scan reliable enough...or should I ask for further testing? I have read it shows fibrosis..etc. but also read it does not. What test really shows the extent of damage? Also, is it possible that I could have cirrohsis (spelling)? even though my enzymes were normal on the last test?

Thankful for any info on this.

[AyrshireK]

Sounds like it is fatty liver, the CT would have picked up if it was cirrhotic. Have you had a read at the British Liver Trust page on Non-Alcohol Related Fatty Liver Disease? It might give you some tips on looking after your liver in the run up to you getting the appointment in December. britishlivertrust.org.uk/li...

[artemiss2291 in reply to AyrshireK]

Thanks for the link..I'll check it out.

[MisterX]

If you've been diagnosed with fatty liver you already have a diagnosis you can work from - especially as a scan confirms diffuse infiltration of the liver. If there's some fibrosis then it's likely the inflammation caused by the fatty liver has caused scarring - assuming there is no other cause of "insult (injury) to the liver. Just to clarify terms - as I often do - fibrosis is scarring of the liver. Fibrosis is usually caused by inflammation (which is caused hepatitis - not to be confused with the fact that some conditions are called Hepatitis because they cause hepatitis!!!!). The level of fibrosis tells you how much scarring there is. The final level of fibrosis is called cirrhosis - where the entire liver is full of scar tissue. Sometimes people will confuse you by calling the process of scarring cirrhosis. It's not. There's no such thing as a "bit of cirrhosis".

That being the case your position right now is actually quite simple - and what you should do is the same regardless of the amount of Fibrosis. Have a chat with your GP and get working on reducing the fatty liver if you can. You've got a few weeks before your appointment and could make a good start in that time. Right now the degree of scarring - doesn't matter all that much and your last blood test results are normal.

I say this because It used to be thought cirrhosis was irreversible. It's now thought the earliest stages are reversible as long as whatever is causing the injury to the liver is stopped or reduced to a level below that of the liver's natural regenerative capability.

So were I in your position I'd take it as a warning to get the fatty liver infiltration dealt with NOW if at all possible. That may mean changes to diet and exercise. People here will have lots of recommendations on that subject so do please feel free to come back to ask.

All that said - if the CT scan isn't showing cirrhosis - extensive scarring - there isn't likely to be a need to do a second test for it - usually a biopsy or possibly a Fibroscan (I don't have experience of that test). As far as I'm aware they would use the CT scan to drive that decision and it doesn't sound from what you've said that it is at that point. Regardless though you'll want to give yourself the best chance of avoiding cirrhosis.

Best wishes.

[artemiss2291 in reply to MisterX]

I appreciate your reply. You seem to know a lot about this. I trust what you say. I am really working on what I eat. In fact, I have cut way, way back on carbs. Sugar is also OUT of my life.

I'll keep on with my diet, and when my appointment comes up I'll ask a lot of questions. This Dr. is one of the best, so I've heard.

[Marydel63]

Hi I was diagnosed with a fatty liver years ago and back then they said not to worry only fatty liver. Years later fatty livers are on the rise and so is cirrhosis. I currently have been diagnosed with stage 3-4 fibrosis=cirrhosis. All from a fatty liver. Never drank , drugs or anything but I am way overweight , obese . I have had ct mri’s, fibroscan, But to actually see what my liver was up to my doctor had me have a liver biopsy which confirmed cirrhosis. So I also have some lesions on my liver which are LRADS 3-4. Which are high risk for liver cancer so I need to have MRI of my liver every 6 months to monitor for liver cancer. My blood levels are normal, at times they increase slightly. So everyone is different. I have been trying to loose weight exercise and eat healthy. My last MRI looked better.

Hang in there and good luck, make a list of questions to ask your doctor before going.

[Hidden]

Mister X said it quite well here. First I'm glad he pointed out the to often the mistake of fibrosis always being called cirrhosis. To reaffirm his point: Cirrhosis is fibrosis in the 4th stage. So fibrosis stages 1-3 are not cirrhosis. Also as he stated the 4th stage was given a " special name" because it was once considered to be the stage in which fibrosis was irreversible. However there are stages of the Cirrhosis category as well and we are now seeing reversal from the earlier categories of it. Because of the knowledge we now have it has been proposed that the name Cirrhosis be changed to advanced chronic liver disease. Regardless of all that I would agree that if a CT scan did not pick up fibrosis than it's safe to say you likely don't have any or it is very minimal. Even if you did have cirrhosis you clearly are not in the decompensated stage of it and often and mostly cirrhosis in earlier stages can be halted if the insult is taken away or lowered to where the liver can handle it as mister X says. But it is important to not let it get there and take this as a warning to change things up a bit. Can you ever eat shit food again? Of course you can but clearly it's being done to a damaging level currently. Can a person with alcoholic liver disease have one drink safely on a medical level. Well it's been argued that yes they can. Why? Because small amounts of the insult are very unlikely to advance disease as long as the amount is still tolerable by the livers ability to cope without stress. But a doctor won't say go ahead on either of those simply because the truth is that if someone has gotten liver disease from any type of over indulgence it's very possible they will over indulge again. That being said give your liver a good chance to bounce back and try to stay off the insults to it entirely for a while. A vacation of sorts at the very least. Lifestyle change is only hard at first until it truly becomes your lifestyle.

Best of luck!

[artemiss2291]

Wow...thank you for this wonderful, informative post. I am "grieving" the loss of junk foods a this point, but I know I will do fine. I am doing 'ok' with my diet of healthy veggies, some fruit, and a protein drink. I have heard different opinions on protein. That is my next question. Is it okay to consume a protein drink everyday when you have fatty liver? I like the way it makes me feel fuller. The taste is not so bad either. I put 3 or 4 strawberries in it, or blueberries, and 1% milk. (sometimes just use water). A few walnuts at times too. It makes a pretty tasty drink.

Thanks again, to all of you, for the detailed info. I love these message boards. You guys are awesome.