Call from GP

[Neednanswers]

I got a call from the GP this evening regarding an ultrasound that was done over 4 weeks ago saying they wanted me to go in for a face to face.Ultrasound was to check gallbladder due to pain under ribs. It was requested back in December.

I'm female aged late 50s, not overweight, teetotaler, eat healthy. But I've always struggled with my cholesterol and I think it's because I've had a lifetime of stress, including a stressful job.

She called me this evening saying I had I filtration of fat in liver. Why would I have that if I'm not overweight etc?

She then wastes another 2 weeks as that's when I've to get the face to face to 'chat about the liver and other things'. She asked if still getting pain - yes I am. She asked why I didn't go back in - because you didn't get back to me with ultrasound results sooner so I thought pain was a muscular thing.

If all is ok enough to waste 6 weeks (from date of ultrasound till next GP appointment), why would she say I'll need a referral to gastroenterology?

I don't have jaundice but do get pain in right groin/appendix area and lower right back area every few weeks. Pain, including rib pain, has been around intermittently for around at least a year.

I'm guessing it must be serious if I need referred to gastroenterology but then don't understand why they left it down long. I'm wondering if they forgot to call me.

[Neednanswers]

Infiltration of fat I mean

[jbrking]

so sounds like non alcoholic fatty liver, I have the same. And like you I’m not overweight but have high lipid profile - fats in blood like cholesterol, triglycerides, gamma gt, and alt in liver. Stones in gallbladder can also be an issue, I’ve had one in mine for about 15 years. It can give pain. Do you have any toilet issues, I have bile acid malabsorption which basically gives me diarrhoea. Perhaps GP is referring you for more tests.

[mickeymouse42]

GPs have very limited access to diagnostic services.

Your pain and the level of fat is a good reason to get some more imaging tests done by the gastroenterology department.

An MRI of the gallbladder and pancreas will give a more detailed view of what's going on - e.g. do you have stones in your bile ducts and gallbladder. Elevated cholesterol levels can lead to gallstones.

A fibroscan to measure how much fat you have in your liver would also make sense.

[Neednanswers]

Thank you for replies. They said the gallbladder was normal and no gallstones. When I have the rib and flank pain, I can hear a lot of gurgling in stomach. When I have the right groin and right lower back pain, I have toilet issues (constipation). They didn't wait 4+ weeks. I found out they left a voicemail on a number I told them in the week I got the ultrasound, was temperamental and didn't always play voicemails so had updated to a new number, which they didn't implement. I hadn't heard back so called to give the new number again, which is when I got the call from the GP. The scan was originally booked 8 weeks ago but had to cancel as had bad flu. Now feel I've wasted weeks. Also concerned it might be pancreas related - she said 'other things'.I tried to get a sooner appointment but couldn't.

Why do they want to see me to 'have a chat about ultrasound and other things' first and not just refer to gastroenterology?

It's either bad news or they think I'm an alcoholic. I'm starting to worry.

[Neednanswers]

Would someone advise please? Why is it a gastroenterologist rather than a hematologist? Does that point towards the pancreas?

[kensimmons in reply to Neednanswers]

Appendix?

[NieceByMarriage in reply to Neednanswers]

Quite often a hepatologist is also a gastroenterologist. Not all hospitals have a dedicated hepatology department so the hepatologists work out of the gastro department. I would not read specifics into the position just by what department you have been referred to. Hope all goes well for you.

[Neednanswers]

Hepatologist

[AyrshireK in reply to Neednanswers]

Gastroenterology deal with every bit of the gastrointestinal tract from mouth hole to a**ehole so they could be examining any bit of that for the problem area. Hepatology deals ONLY with the liver and biliary system.

Most folks only see gastroenterology even for their liver problems as hepatology departments are rarer to find (our health board area doesn't have any hepatology specialists only gastro's).

Katie

[Neednanswers]

Thanks for replies. It was this one GP who took me seriously ( one who arranged the ultrasound). He was great. The others put it down to arthritis and advised me to self refer to physio.

[Neednanswers]

I'm also confused about statins. If someone has fatty liver, should they be on statins (atorvastatin)or do they make fatty liver worse?

[Snowhite6]

Did you get to see your doctor ?

[Neednanswers]

Finally saw gp today. They did bloods 10 days ago. Everything more or less normal - B12, FBC, thyroid, liver, cholesterol. Kidney function reduced so getting redone in 2-3 weeks. Sugars highish also but not diabetic. I'll cut salt etc, drink more water, exercise until next kidney bloods. Got the ultrasound report also. It says -liver slightly enlarged, echo bright showing fatty infiltration. What is this ? - wedge shaped area with decreased echogenity (2.7cm by 1.9cm), in keeping with focal fatty sparing.

Portal vein patent with heapatopetal flow. No free fluid.

Kidneys, pancreas, spleen, etc all normal.

If I have fatty liver, what's 'fatty sparing wedge' ? I thought sparing meant there's no fat in that area??