Update on results - Do I need to push for further investigation?

[Thumberlina]

So having told the GP my alcohol consumption was way more than the 7 units they had me down for and my love of sugary sweets they ordered a retest. This time full liver screen as well as GGT/AST, all apparently are within the normal range (mid not high or low). This is obviously very good news, the hepatitis test has not come back yet but she is confident it will be fine based on other results?

They did however take a stool sample when they done my original bloods and the results of this have come back abnormal. I apparently have H. pylori bacteria infection which they are starting treatment for straight away.

However, she now believes the masses that were seen on the Ultrasound I had 2 weeks ago (privately) are Hepatic haemangiomas. They have not seen the images which she said they cannot accept as it . I had a previous ultrasound back in 2015 where they noted they believed a 25mm mass on my right liver lobe was a haemangioma. This is now where i have a 52mm mass at the largest point, as well as one on my left lobe which measures around 25mm.

I'm told my "parameters" don't warrant further investigation and as I referred myself for the ultrasound therefore it is not part of their investigation.

My lifestyle changes are implemented, i will not be going back to the sweet eating wine drinking person who scared herself half to death. Given the changes I have made , I know you guys can't diagnose. Could she be wrong? Should I just accept this or should i be pushing for them to find out what they are?

[hells456]

Hepatic haemangiomas are fairly common and the small ones under 10cm do not usually need any treatment. Your bloods are good, your ultrasound was fine, which are both things to be very grateful for. What else do you want to push for? Keep up the good work you've done with your lifestyle changes, you're doing great.

[Thumberlina in reply to hells456]

The sonographer wrote an advisory to the doctors that the 2 masses she had found that showed no blood flow should be further investigated by other imagery. My GP has said she will not consider the results of the ultrasound as I arranged it myself.

The same GP has given me the wrong prescription for the diagnoses she believes I have which is a bacterial infection not a liver problem, the pharmacist picked up on it. Getting this resolved whilst not being allowed in to the surgery and other restrictions has been somewhat of a nightmare. I also note, I have had previous symptoms that pointed to my liver, all 4 were treated in isolation. The only symptom I still have after cutting out everything is the pain in my upper abdomen, below my ribs, which she has said is likely muscular. she has made her diagnosis over the phone, having never even examined me.

I just do not trust GP’s in general nowadays. You can never get an appointment with the same one, when you do they seem hellbent on prescribing creams and potions. My previous experience in february after suffering for almost 2 years with pain I was told my foot was fine looking at my x-ray, manage pain with the standard paracetamol/ibuprofen, gets too much, come back and we’ll give you something stronger. Booked a private appointment with an osteopath who advised me to get a bio mechanical assessment. Booked this privately and low and behold, my entire arch had collapsed....the only fix being prescription orthotics they made by moulding my feet.

My wish to know should I ask for investigation on these masses is nothing more than other peoples experiences. Could these masses be something that needs to be investigated? or do I just take her word based on phone conversations and her belief she is correct that my liver is fine given all my good results.....either way, I have made changes to my lifestyle so this can only improve my liver.

[hells456 in reply to Thumberlina]

I'm sorry you are under so much stress with this. The trouble for you is that as your results are fine very few doctors will want to run unnecessary tests, especially when seriously ill people have to wait a long time for them. Hepatic haemangiomas like yours can be scanned every year or two to keep an eye on them, but don't need treating or further investigation unless they are very big, which yours aren't.

I'm not sure what other symptoms you have, but blood tests are the biggest indicator of liver health and are very reliable. If your tests are fine then you should be looking to see what else could be causing them. If you are not happy with your GPs, is there another practice you can join? I don't know what other tests could tell you, imaging has shown you have fairly common harmless haemangiomas. Fibroscans give a rough idea of the level of fibrosis, biopsy is good for distinguishing between PBC, PSC and AIH, but if any of those were a concern it would show in your blood tests. You could give the British Liver Trust a ring and have a chat to them. What would reassure you that your liver is fine?

I was diagnosed a year ago and in the 18 months before that I had a lot of symptoms, my muscles melted away, I lost my sense of smell, never hungry or remembered to eat, insomnia, dreadful itching, cramps, tiredness on a level I couldn't have imagined before and constant little bugs and infections. The only pain I had was in my joints. I thought I was dying and yet I finally went to the doctor for a yellow lump over my eye, not the other stuff and was diagnosed within a week. I hadn't thought of my liver as there were no pains or sensations there, I've never liked alcohol and didn't think an organ would be clapped out at 42. My doctor told me that liver disease is usually silent until it starts struggling because it doesn't generally cause pain.

Living with the stress you are under is very hard and I hope you find some relief soon.

[DpJ1]

Hi thumberlina,

Just read your post and can completely empathise as I've been through something very similar and I'm still no further forward in a diagnosis. I think, and from what I've read about GP(NHS) protocol/referral, unless you've got cirrhosis on US or your alt/AST/ggt is way out of norm their not manndated to reffer.

Since my pain in my upper right started I've also been given the runaround and treated for my symptoms separately and now told I have stres and anxiety 🤯. I've been trying for seven months and I would guess if you push for more you might get the same. I went private had some bloods done what I could afford , positive for anti smooth muscle antibody, GP won't acknowledge, even though could be a sign of liver probs. Can't afford any more private test or treatment or I would. Don't think NHS have heard of pre emptive, preventative diagnoses/treatment unless it's cancer. I'm still trying to get a fibro or mre. If you can go private ( not that you should have to ) you might get quicker answers.