How bad off is my fatty liver?

[ceande]

Hi all,

Happy holidays, my name is Chris and I wanted to put my liver story out there, and see what the thoughts of the community might be as to the extent of my liver damage.

I don’t used get physicals every year, I took it for granted I was healthy and fine. I’m 39 years old, about 190 lbs, 6 foot tall, fairly lean for these dimensions as I was a former athlete and used to work out so I have some muscle.

Anyway, I used to drink way too damn much. Id drink bourbon (the best), boxes of wine, craft beer, you name it, I was a drinker. Loved it. Drank like 30-50 units or drinks a week. Kind of heavy.

Anyway, my first symptom was I started having some concerns with my stool. It just wasn’t as dark brown, and at times seemed a bit under digested. This progressed a bit and one time I had a stool that was flat out basically grayish. Scared me a lot. After googling it and really freaking out, I ran to the doctor.

Now, I’ve always had regular physicals with blood work, but not every year. I just didn’t think I needed it. I once had low vitamin d, but other than that nothing ever came out of that. No liver indicators in my blood work, ever.

Doctor ran an extra blood test and basically told me I was fine, nothing abnormal.

So, I tried to ignore it for a 2-3 years. Drank a little less, but still drank probably 20-30 / week.

My poop still didn’t seem right, so I faked to my cousin about it (he’s a local ER doc), and he wrote me prescription for an ultrasound. Results showed 18.3 CM enlarged liver.

This was on June 6, and I haven’t touched alcohol since. Got referred to a gastro doc by my PCP once he saw the ultrasound. Gastro told me he thinks it’ll fix itself, and we’re going to rescan it in a few months.

Is 18.3 CM insanely bad? I googled it, and that seems like an extra fatty liver.

I also have mild intermittent liver pain at my right shoulder blade, and occasional burning sensation in my right upper quadrant after meals.

Any one else go through anything like this? What should I expect? Any thoughts or suggestions?

Not planning on drinking again unless the doctor tells me to.

Thanks

Chris

[CocoChannel]

Hi Chris

Can’t answer how bad your fatty liver is except to say a fatty liver is bad news and to offer my experience

I never had any poo problems to my knowledge nor any such detailed ultrasound tests. I did drink similar amounts for a decade or so and had pretty much the same pains you mentioned. A general ultrasound detected a “mild fatty liver”.

I’d been on a bit of a fitness drive in the twelve months before the ultrasound and intentionally lost a lot of weight and cut down (but not yet quit) the booze. I suspect my liver had been fattier before.

I stopped drinking altogether after the ultrasound (I was going to stop anyway), and a private fibroscan eight months later showed no detectable fat.

You were drinking a lot so well done for quitting. Things should only get better. If you were drinking that much, it’s very unlikely you’ll drink moderately (<14 units a week) in future, so think about quitting?

[ceande in reply to CocoChannel]

Yeah. I’m not drinking again ever unless I can definitively put this behind me. And even then, only on holidays and camping trips.

Not daily anymore, for no reason except because it’s a weekday and I’m off work, or whatever. That’s dumb.

[CocoChannel in reply to ceande]

Sounds like a good plan. If you can drink in moderation on occasions and are healthy enough to do so, fine. I found I’d become dependent on alcohol so easiest just to never drink.

[briccolone]

I would listen to the gastro- keep doing the exercises and stay away from sugar and booze.. keep posting.

[ceande in reply to briccolone]

I haven’t been doing any exercises, but I’ve been eating a little cleaner. Trying to steer myself away from carbs and sugar, and eating a lot of plant based carbs and animal proteins.

I’ve lost about 15 lbs mostly just from not drinking I think.

[briccolone in reply to ceande]

that's very good-exercise really helps though if you're up for it...

[ceande in reply to briccolone]

I’ll check into it. Thanks you.

[MalcolmCClark]

Hi I had been diagnosed with a fatty liver and thought nothing of it for nearly 20 years. I had been told to cut out the fat in my diet but other than that no real concerns from the doctors. Move on to November 2017 and I went into surgery for a stomach bypass to help control and reduce excessive fat. I was nearly 150 kg. They stopped my surgery because they found cirrhosis of the liver and reverted to a liver biopsies which confirmed their findings. I had non alcoholic fatty liver disease which had gone into full blown cirrhosis. After 18months the surgeons completed my bypass. I have lost 50 kgs and feel a lot better. I had to give up the booze but now my liver is stable and the dramatic weight loss has reduced the fat round my liver.

My advice is try and keep to the no alcohol routine, exercise and watch the fat intake. If you still feel that you are having problems talk to your doctor. Take this as a warning from your body.

Hope that helps. The liver can recover but you need to allow it to do so.

Good luck

[ThreeSmiles in reply to MalcolmCClark]

Good job Malcom 👍 in the face of that adversity it must have been, probably still is, hard work ....

Miles

[ceande in reply to MalcolmCClark]

Good work Malcolm, and thank you for the information. Way to make a serious lifestyle change.

I do need to add in some exercise, at least a little. I’m going to look into that.

[MalcolmCClark]

It is hard work and I still get fatigued. That I can put up with as I dread the thought of a liver transplant if things go down hill

[ThreeSmiles in reply to MalcolmCClark]

Malcolm - don’t dread it - you won’t regret it for sure. But of course much better if you can keep TP at bay as long as your quality of life is OK. BUT as I understand Quality of Life isn’t in the equation or wasn’t or maybe it is now I can’t keep up, and the criteria don’t seem to be well publicised.

Good luck!

Miles

[Hidden]

Hi Chris,

Welcome to the forum. Are you in the US? We can only really explain about the usual experience of liver testing from the UK system.

If you have a fatty liver here, there are new guidelines to then have further testing for fibrosis ( stiffening/scarring) in the form of specific fibrosis blood tests, or FibroScans. Hopefully you can be offered this where you are.

We do have useful publications on Fatty liver and also liver disease testing on our website, britishlivertrust.org.uk/in...

Warm wishes

Trust1

[ceande in reply to Hidden]

I’m in Kentucky, yes. We have a fibroscan machine, but only 2 in the state (at UK and UL) and in order for me have that done I have to be referred to a Hepatologist. The Gastroenterologist I’m seeing is not associated with the university, so he can’t do it (I asked).

Is there a lot of value in having a fibroscan?

My gastroenterologists plan is to do another ultrasound early next year and see if my liver has gotten any smaller.

[Hidden in reply to ceande]

National guidelines stipulate testing for fibrosis here in the UK if the patient has a fatty liver.

Maybe you could get referred to a liver specialist?

Trust1

[briccolone in reply to Hidden]

really, I've never been offered tests for fibrosis once although I've had a couple of ultrasounds. The only fibroscan I had was courtesy of the Liver Trust roadshow and very useful it was....

[Bootandall in reply to ceande]

Hi, l'm very lucky as my hepatologist in UNC-Chapel Hill (NC) has a FibroScan right in their office. The only thing that l can say for sure, it measures the liver's fatty deposits which sounds like what you are looking at it to do. Get a referral, you can still see your gastro for follow up care.

[B3nnen2015]

Hi chris,

My story is quite similar to yours and we are in similar situations. Here it is.

healthunlocked.com/britishl...

I have fatty liver and slight hepatomegaly/inflamation also.

And i have the same shoulder blade pain which i believe is from the enlarged liver.

I believe the plan to resolve our situations is to simply eat healthy/ exercise and lose weight.

But it takes time.

[Bootandall in reply to B3nnen2015]

And don't we all wish it was that Simple! 👍☺️

[TSManning]

This may be a stupid question but how can they tell the liver was enlarged? From what I understood it was the consistency/smoothness of the liver they look at through ultrasound and can see fat deposits as well. Was any of that showing fatty liver as well?

[TSManning in reply to TSManning]

Also were your lft’s elevated at all?

[B3nnen2015 in reply to TSManning]

They can masure it with the ultrasound too

[TSManning in reply to B3nnen2015]

The reason I ask is mine measured what would be considered large but neither my doctor nor whoever read the ultrasound pointed that out. I had no fatty deposits and it was noted as being smooth in contour. I have always had Norma lft’s and he a laparoscopic surgery in March where they took pictures of my liver during the procedure and nothing was noted as being off there either. Should I now be concerned and stressing about the measurement?

[B3nnen2015 in reply to TSManning]

Its the fatty infiltration that makes the liver swell up and damage it.

If you have a naturally larger liver and the ultrasound found smooth and no fat and nothing wrong then id say you have no reason to worry

[ceande in reply to TSManning]

No

[TSManning in reply to ceande]

Mine measured exactly the same in size ironically enough, but no one mentioned fatty liver to me...

[ceande in reply to TSManning]

My bloodwork has never shown any irregularity except that it once showed that I had a vitamin d deficiency. That’s why my PCP never sent me for any additional testing.

But I didn’t agree with my doctor, so I discussed this with my cousin who is an MD at a nearby ER.

He ordered me a prescription for an ultrasound (which measures the liver, that’s how I know it was 18.3cm).

The ultrasound tech did make a note on my ultrasound report that “liver was smooth, and no sign of liver cirrhosis”.

18.3 cm is too large though.

This ultrasound is the only medical evidence of my fatty liver, hereto.

[B3nnen2015 in reply to ceande]

Again, i am the same.

Normal bloods but enlarged fatty liver. On US

It didnt mention anything about the liver texture but id imagine if it was anything but smooth/normal then then it would state so. So that's agood sign.

From what i gather from reading this page and others is that everything is reversible, until its cirrhosis.

Sothe idea is to healthily lose weight until the fat leaves the liver before it does too much damage in there.

Ben

[TSManning]

Ok so then not seeing any of that would mean it could just be naturally large with no reason to worry? I worry because I’m 35 and for about 5 years drank more then I should have. I have since cut back to a glass of wine occasionally on the weekends but still feel guilty when I do that...

[ceande in reply to TSManning]

I think livers are supposed to fall within certain size dimensions. At 18.3cm, my liver is much much too large. That would be like having a 4 foot wiener, it’s like damn, that’s a bit too much.

LFT’s don’t always indicate in bloodwork if the damage is already done.

My understanding of those is those will indicate while the damage is being done or progressing.

[TSManning in reply to ceande]

Agreed, and I’m a female so mine measuring that large is even worse. I had come to terms with everyone telling me I was fine now I’m scared all over again.

I did have lft’s done while I was drinking at my heaviest and nothing ever showed. I also went through three pregnancies of obviously no alcohol so my body has had time to recover.

[TSManning in reply to TSManning]

They should have still seen the fat infiltration though from everything I am seeing. Did they note that in the report as well?

[ceande in reply to TSManning]

I think once they can notice a change in texture of the liver on an ultrasound, that’s considered permanent scarring / cirrhosis at that point.

My understanding is that a fatty liver has the same smooth texture as a healthy liver until it becomes cirrhosis.

[TSManning]

It can indicate fibrosis, yes. But the fat would also show, it shows bright and grainy on the ultrasound and they should have noted that too if that was the cause. That’s not something that’s normally missed because it is so evident in the ultrasound.

[Bootandall in reply to TSManning]

There are differences in US, some are more detailed then others. I am obese, my doctors ordered an MRI with contrast to get the level of detail they wanted.

[Bootandall in reply to Bootandall]

I should add, this was after the Fibroscan showed cirrhosis. Regular scans, every six months, are part of my follow up care.

[B3nnen2015 in reply to Bootandall]

Hi Boots, did you have ultrasound First?

What did it show?

[Bootandall in reply to B3nnen2015]

Hi,

I actually had a Fibroscan first, which diagnosed me with cirrhosis and fatty liver.

Then US, then I started getting MRI w/contrast because they wanted a clearer picture of a hemangioma on my liver, which is a small bundle of blood vessels.

I also had another Fibroscan recently, to see if the fat was any less (it was).

[TSManning in reply to Bootandall]

Did the ultrasound give the same findings?

[TSManning in reply to Bootandall]

But an ultrasound should still show fatty liver pretty easily from my understanding, no? I am not overweight at all so I’m hoping this was an accurate reading. However despite showing no fat my liver measured 18cm which I am a female who is only 5’4’’ and 120lbs. This is large but when I asked my doctor specifically about the size he said he wasn’t concerned and everyone’s liver is different.

[Bootandall in reply to TSManning]

That's interesting, but l have no idea what size mine is or was, so wouldn't know any different ! Unless your doctor is a specialist, you may want to at least get another opinion, have a peek at your report or sonogram pics.

[TSManning in reply to Bootandall]

No, it wasn’t a specialist. It was my primary care and he said there was absolutely no reason to refer me out as everything looked great. Just told me to be smarter with alcohol moving forward and that was it. The ultrasound tech who read the report also didn’t note anything suspicious on the size even which I assume they would if they felt it was enlarged?

[Hidden in reply to TSManning]

I have been criticized for stating my liver was never enlarged despite cirrhosis. During a US, The radiologist nurse asked why I was referred & do they suspect an enlarged liver. It looked normal with no abnormal lumps or bumps. Note I've read up Enlarged, swollen and/or inflamed are separated terms. Inflammation doesn't necessarily mean enlarged or swollen. 🤔

[TSManning in reply to Hidden]

So you’re ultrasound was normal despite having cirrhosis? I also had laparoscopic surgery on my abdomen where the doctor took a picture of my liver as a part of it and never said anything about it looking abnormal. I just reviewed my ultrasound again and the measure was 16.8cm, the findings were noted as a normal upper right quadrant ultrasound.

[Hidden in reply to TSManning]

Yes correct. That was the result of my latest of 3 back in Aug the latter scan after diagnosis in April. My cirrhosis is described as mild such as it is.

[TSManning in reply to Hidden]

Should I be more worried then? I haven’t had any symptoms, my bloods have always been good and ultrasound should normal as well aside from me questioning the measurement.

[Hidden in reply to TSManning]

I wouldn't be fit to comment for 1. I haven't read the full post to be honest. I just picked up on this point. I can confirm that 3 years ago I thought mine was fatty though it was never describe as such. I was bluntly told lose the Alcohol or lose the liver. But foolishly I didn't. I cut back but old habits die hard and I fell back into the too much too often. 😭

[Bootandall]

As l stated earlier, l don't remember anything being said about the size of my liver either. l do know that the liver actually shrinks if you have cirrhosis, and there are textural changes.

Your question made me research a bit further. l was reminded then that my spleen is enlarged. In my case, I have a history that includes my platelets dropping due to chemotherapy, a blood transfusion which gave me hepatitis, which left untreated for 40 years led to cirrhosis. It is my understanding that my enlarged spleen is due to inflammation caused by the chemo (and possibly the cancer leading up to it), the Hep C virus, and finally due to cirrhosis.

So maybe your liver is inflamed, it could be due to alcohol, or medications, or an autoimmune condition. I didn't think l drank that much, but after three years of abstinence, I have lots less swelling in my entire body. Places l didn't realize l had swelling, and l am fat and on a diuretic! I don't think it's a good idea to worry needlessly, but if you feel something is wrong, trust that you know your body best and investigate it.