Nuerotic Cirotic. Can Drs be wrong?

[beznoswal]

Hi BLT,

Been subscribed to this forum for a couple months. Super kind people I must say. Typing this on my phone so apologies for typos. 39 year old Male from Australia. Have been a pretty consistent beer drinker for 10 years. Every second day at least, maybe 10 units/standard drinks a sitting. The couple spots on the top of my chest one day concerned me enough to investigate and found out about spider naevi. Saw my quack he confirmed they were that and sent me off for blood work to 'rule out liver pathology'. All those came back really good I his words. I asked for an ultrasound and I went for the whole abdominal area scan. Came back normal no echotexture, normal size, etc. He is convinced and was trying to convince me my liver is fine. The naevi have not been explained except for his suggestion I had a mild case of alcoholic hepatitis. All the time I'm thinking the worst. Is this something any one else has occurred with the dreaded naevi but a super optimistic doctor saying everything is fine and not needing further tests. I have zero other symptoms, full energy, etc. I haven't drank in a month and feel great, talk about playing life on hard mode. Any advice or words would be appreciated about what direction I should head in or how I should be approaching this. Thanks!

[Hidden]

Hello and welcome here,

The best thing that you did was to get yourself checked over by a doctor and tell him about your drinking, you have recognised the issue early.

You now need to make the adjustments to your lifestyle, to prevent any further damage. The liver is a robust organ and needs looking after.

Look at the drinking and get support to help you to continue your abstinence.

You also need to follow a healthy and balanced diet and get plenty of exercise. Take all the advice that your doctor gives you.

Good luck with everything.

Mark.

[beznoswal in reply to Hidden]

Thanks Mark. Any experience with spider naevi?

[Hidden in reply to beznoswal]

I was diagnosed with end stage decompensated cirrhosis, it comes with lots of problems and best avoided. You can avoid that scenario by looking after yourself.

I have been transplanted 8 months ago and am progressing well.

[beznoswal in reply to Hidden]

Sorry to hear that mate. Can I ask about your symptoms? Any spider naevi early on or later or not at all? Good work on the transplant does it make an immediate difference?

[Hidden in reply to beznoswal]

Yes, it keeps me alive. The symptoms are too long to list, listen to the doctors and follow the advice. They will check the veins.

Good luck,

Mark.

[beznoswal in reply to Hidden]

Thanks. Yeah after some advice on the naevi. Doctor said my portal vein was 11mm. Good luck man

[AyrshireK in reply to beznoswal]

Spider Angioma or naevus arn't necessarily due to liver illness, common and visible in 10-15% of the population. If your ultrasound was clear then that sounds like good news.

bad.org.uk/shared/get-file....

Katie

[beznoswal in reply to AyrshireK]

Thanks Katie. What's your take on them for a person whose otherwise healthy, but been a drinker and could be at risk. They seem like the sinister way to describe liver disease.

[AyrshireK in reply to beznoswal]

I can't really comment, you've had an all clear ultrasound so that's good news. Make booze a thing of the past and any liver ill health you might have should reverse or at least not advance. As your doctor said you might have had a bit of alcohol related hepatitis i.e. alcohol related liver inflammation. There are more obvious signs when your liver is beginning to struggle, spider naevus appear in healthy people too so they arn't necessarily anything at all to do with your liver.

[beznoswal in reply to AyrshireK]

Thanks Ay. Is there any consensus you know of spider naevi being a warning shot from the liver early on? Are those healthy people with them defined as non drinkers?

[AyrshireK in reply to beznoswal]

Children can get them so they are common including in non-drinkers.

Yours may or may not be linked with your drinking. Your doctor intimated liver inflammation so it would be wise to knock the drinking on the head.

[beznoswal in reply to AyrshireK]

Thanks for the reply. I guess I'm left wondering why I might have them with a dr saying - it's one of those things. Just wanted to get the general consensus.

[beznoswal in reply to beznoswal]

What is the worth of LFT and a US. They seem very token tests.

[Hidden]

Spider naevi are one of numerous signs that can be suggestive of cirrhosis. A liver may appear normal with an ultrasound but be fibrotic or cirrhotic.

I live in Australia & when I had symptoms suggestive of liver disease I was referred to a gastroenterologist who sent me for an ultrasound & elastography. The ultrasound checked liver size & shape & the elastography measured liver stiffness to determine if my liver was fibrotic or cirrhotic. An ultrasound alone won't necessarily do this.

Any GP can send you for elastography or a FibroScan (they are the same thing) however if your GP is unwilling to do this then ask for a referral to a gastroenterologist who will send you for elastography or a FibroScan to rule out fibrosis & cirrhosis. If the technology is available to determine if your liver is fibrotic or cirrhotic why not use it?

[beznoswal in reply to Hidden]

Thanks Edward for the in depth reply. My doctor was super sure it wasn't cirrhosis and said a fibroscan would not be necessary. He did not refer me.

[beznoswal in reply to beznoswal]

How was your US result?

[Hidden in reply to beznoswal]

I had two ultrasounds & two elastography scans 9 months apart plus an MRI ordered by the gastroenterologist I saw. Each elastography was performed straight after the ultrasounds using the same machine. I think the technician just attached a different probe & flipped a switch. None of them found anything wrong however the gastroenterologist agreed that I did the right thing stopping painkillers when I did given that my blood tests over the past 5 years had multiple abnormalities with my GP making light of them when he shouldn't have. I still have a low platelet count & slightly raised ALT despite living clean of painkillers for 18 months. The reason for my continued low platelet count & raised ALT remain unknown.

When the first GP I saw refused to refer me to a gastroenterologist I saw another GP for a second opinion who wasn't as arrogant as the first one. He referred me to a gastroenterologist to rule out cirrhosis or fibrosis. Because the gastroenterologist didn't have X-Ray vision he had no problems with using available technology to make sure that my liver was not badly damaged.

If I were you I'd see another GP & explain your drinking history & show him the spider naevi & say that you want to be referred to a gastroenterologist to be checked for fibrosis as well as cirrhosis. You may not have cirrhosis but if you have spider naevi you might have significant fibrosis & you have a right to know this. A FibroScan by measuring liver stiffness can determine if you have fibrosis & how bad it is. An ultrasound scan can't do this. Let's say the FibroScan score turns out to be 10.0 kPa. That would mean your liver was heavily fibrotic and not far off being cirrhotic. I believe that this would be worth knowing even if the GP you saw doesn't.

[Done32119]

I am in the exact same spot as you. I am 29 male and drank heavy for 5 or 6 years a similiar amount as you except mostly every day. Confirmed spider nevi. On my chest and ankles. Hands super red (palmar errythema) but thats self evaluated may be in my head. all blood work came back good. Doctor says I just have fatty liver and health anxiety. I am trying to push him for more specific testing like a fibroscan or fibrosure test now.