Big Liver, normal? Confused: Hello all... - British Liver Trust

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Big Liver, normal? Confused

Hello all.

I’ve had upper right quadrant dull pain for 8 years now on and off. I’ve had blood work and ultrasounds done multiple times and all have come back normal. The last ultrasound results came back normal, but I noticed the size of my liver came back as 17.4cm. Everything I have read has told me this is enlarged but my GI and GP have both told me it’s normal and nothing to worry about. I have anxiety and went off of my SSRI 6 months ago, so I’m aware I could be overly stressing/obsessing about this. I’ve also had some insomnia and stomach issues, but as I said I have anxiety have have been diagnosed with IBS. Just wondering if 17.4 cm on an ultrasound could really be normal? I’m not a large person, 5’ 4 and 138 lbs. I do drink alcohol but I’m not an alcoholic. Thanks for any feedback!

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You are right—17.4 cm is large for a liver particularly for someone your weight & height. Also I presume that you are female from your username & females have slightly smaller livers than men. Ultrasound scans measure liver structure not whether the liver cells are healthy. Your normal blood test results are a good sign indicating that your liver function at the time the tests were done was normal. Your liver may be healthy & just naturally large but if that's the case it's unusual. My mother had an enlarged liver mainly caused by long term use of medications & her liver became cirrhotic.

I'd want a FibroScan to confirm that your liver is healthy & I'd give up alcohol if I were you at least until the FibroScan confirmed that your liver isn't enlarged due to some type of pathology. Given what I now know I wouldn't accept the word of the GP or even your GI. Neither of them have x-ray vision & they can't guarantee that your liver is 'normal' despite its larger than normal size solely on the basis of blood tests & ultrasound scans.

If your liver is enlarged due to things like taking medications, drinking alcohol etc. in the past then knowing this would mean that you could do everything possible to prevent it getting worse. Better to be safe than sorry & have further testing done to confirm whether or not the GP & GI's opinions (which are basically educated guesses) are right.

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Thank you for your response. Yes, I’m a 34 yr old woman. I do feel a little dismissed by my doctors. So if the Fibroscan shows something, does that mean I’ve had previous damage to my liver? Or would it show something that is going on right now that the blood tests and ultrasound didn’t show? I do try and live a healthy life style and besides the ssri anti-anxiety medication I took for 7 yrs, I’m not big on medication. That being said, I have struggled with Epstein Barr and do socially drink alcohol which I would absolutely give up if I knew it was affecting my health. Thank you for any feedback.

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A FibroScan measures liver stiffness & whether your liver has any fibrosis (scarring) from things like drinking alcohol, taking medications etc. in your past. It would also determine whether your liver is cirrhotic.

In some people when a liver struggles it becomes larger although it doesn't happen with everyone. It happened with my mother. The longer she took medications the more scarred & the larger her liver became until it became cirrhotic & she died from cirrhosis.

Another possible cause of a liver getting larger is fat infiltration. As long as this isn't accompanied by inflammation then it's not a serious problem. Your normal blood test results indicate that your liver isn't inflamed so if it's enlarged due to fatty liver it wouldn't be a problem however you shouldn't drink alcohol.

There seems to be no uniform agreement as to what a normal size is for a liver but even based on the largest size classed as normal that I've seen yours is larger than normal.

Dr. Melissa Palmer's Guide To Hepatitis and Liver Disease:

"The size of the liver is variable. Despite what most people think, a cirrhotic liver may stay the same size, shrivel up, or enlarge (a condition known as hepatomegaly)."

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Yes that is what I have found also, anything over 16 is considered enlarged. That’s why I’m confused I’m being told to not worry about it. I’m sorry about your mother. Thank you for the information and I will inquire about getting a Fibroscan. I think I may check out a different doctor too.

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As well as a FibroScan you should request a CAP score to measure fatty infiltration of the liver. Fat infiltration is a common reason for an enlarged liver like you have. If your liver is enlarged due to fat build-up it's fixable through lifestyle changes. If it's enlarged due to inflammation & scarring that's fixable too if caught before cirrhosis occurs. Ignorance is not bliss. Knowledge is power!

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My demise healthwise started with EBV. It's a very nasty virus and not everyone makes a full recovery. Tell your Dr you want to see a liver specialist, . I was diagnosed with fatty liver by a gastroenterologist, said lose weight but that covers a very broad spectrum. next fibroscan showed severe liver fibrosis in spite of losing 2 stone, which I had no idea fibrosis was very serious! I was on a drugs trial when I contracted EBV, I have psoriasis and felt it was only right I volunteered when asked. I had been on the drug not placebo. 3 years on I got funding for the new drug, it was not thought to be connected. I had 1st injection, I felt like my EBV had returned. I had the 2nd and very poorly. I could not bear light sound, only sipped water and was bedridden for 6 weeks. I had had a cytokine release storm.It can be fatal. I was diagnosed then with ME and fibromyalgia. I then went on methotrexate injections. I had no side effects and it worked. I was monitored, bloods lft's etc. I was on it for 7 years. It can cause liver damage and so Dermatologist asked for my liver to be checked I just had fatty liver. 2nd test severe fibrosis. I am one of the 2/3% of people who get severe liver damage from metho, now I have cirrhosis, even though T came off Metho a year ago in January. I asked to be referred to a Liver centre. I went on 5 December and this is when cirrhosis diagnosed. The Prof I saw said psoriasis can cause fibrosis and so can a virus like EBV. Under choose and bool you can ask where to be referred to . I looked for a hospital that had a liver centre and was also a teaching hospital. If you look online you can checkout which hospitals offer all this I live in the North West so went to Royal Liverpool. I am sure members on here can help on this, if you say where you are in the UK? I haven't drank since EBV - I could not stand the smell let alone the taste! Your liver may be perfectly fine, but stress and anxiety is not good for anyone. Be assertive and do not be brushed off by any Dr. Some are amazing but some are definitely not Hazelx

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