Liver symptoms appeared after treatment

[Motik]

Hi, guys, Its been 3 years since I last wrote. I had some liver issues back then which which disappeared some time at the end of 2021 .During that time I had made 6 fibroscans in different medical facilities, I had 2 biopsies, gastroscopy...blood tests and so on. It show nothing but Hepatitis C with low viral load... So I did a hepatitis c treatment January 2024. Till April I was clean of the virus .. 3 months later im still clean. After end of hepatitis treatment I had one treatment for optic neuritis with high dose corticosteroids. After I finish with the treatment from this neuritis all was good till the middle of June. Just to mention that for 5 years I have several times drinking wine.. I dont like alcohol because after two glasses im really drunk. In the end of June I started having dull aches in the RUQ and nausea started.. I didnt wait and went to my local gastro and he I he looked me in Ultrascan and did some bloods... The tests were ok except AST was 17 and ALT was 10 (after the end of the treatmen they are like this, the ratio was normal before the treatment), and my creatinine was lower 53... thich is wih 10 units lower than the low limit... He said im ok and sent me home. I could not stand because I didnt felt well and I went to a second gastro. She made a ultrasound and said that lives looks ok, the only thing she saw : there are lots of stones in your gallbladder.. bigger, smaller, but there are lots of them.. she saw my bilirubins are ok and said nothing more. She said that because of the steroids i was treated I maybe got CMV or epstein barr. She made blood tests and she send me home.. On the next day the tests were ready. and both were negative... Since than I am again confused and I dont know what to do... Im on work visit now, tryind to ignore whats happening. The symptoms have subsided, there is still a dull ache, but it's not like before... Since the symptoms started, I started eating healthier and lost 3-4 kg. I am asking for your opinion on what to do from here on out?

[Dogbot]

my only suggestion is, have you got a liver team you can contact they would have your medical records and maybe some suggestions. I hope you can get some answers good luck.

Stay safe All

Dogbot back from America 🐶🌈Dave

P.S terrible Jet Lag 🤣😂

[Motik in reply to Dogbot]

I have an appointment next week with the team that treated my hep C... Still Im afraid my liver got worse and the symptoms are driving me crazy... Im also wondering if the fibroscan will be enough or I will need biopsy again.. so.many stress..

[Dogbot in reply to Motik]

It’s not easy but try to take it easy and not worry too much , I know it’s hard to do but do try. There is nothing to do until you see the team and I’m sure if they thought there was something that was serious they would have contacted you. Good luck hope it goes well 👍.

Stay safe All

Dogbot 🐶🌈Dave

[NieceByMarriage]

Please let us know what your liver team said. I completed Hep C treatment recently. I don't yet know if the virus is cleared as the hospital messed up my blood test and I have to go back for another one. However I have been getting dull aches in my liver region consistently, and an occasional very sharp pain. I had the sharp pains before but they went away for a while when I started the drugs. My liver enzymes have gone back to normal but the AST/ALT ratio used to be just under 1 and has now moved to 1.6. Until reading your post I was not aware that AST/ALT ratio was even a thing, so thank you for that. I will be raising the issue with my own liver team when next in contact with them.

[Motik in reply to NieceByMarriage]

Hi, NieceByMarriage.

Sorry to hear that they lost your tests….….

My first question is: as I uunderstood you still have the dull pain?

And my second is: do you have fibroscan test, and if yes, what are the results?

To be sure I went to private labs and paid for all 3 HCV-RNA tests (80 euro each). I did the first one a month after starting the treatment.. And I was negative. I did the second one a month after the treatment and I was still negative.. the third one I did 3 months after the treatment, again negative. In other words, the treatment is highly effective, I was treated with VOSEVI. I'll keep you posted after I get my checkup next week.

[NieceByMarriage in reply to Motik]

Yes, I still have the dull pain. And the sharp pain. The sharp pain is only ever triggered by movement. I have tried and tried to replicate the pain in case it is nothing to do with my liver. If I can replicate it then I can see a physiotherapist to see what they have to say, but no particular movement will ever cause the pain when I am trying to trigger it.

I had a fibroscan. Can't remember the numbers but it was at the lower end of F1, so nothing that concerned the doctors. The machine they used did not give a Cap score. Previous ultrasounds, MRI and CT scans did not show anything of concern to do with my liver. I do not 100% trust the results because at the time we did not know of the Hep C so the tests were for general diagnostic purposes. They were not therefore specifically looking only at the the liver - and these tests are only as good as the radiographer interpreting them.

I was on Zepatier and it has something like 96% success rate, so I am fairly confident the Hep C has gone. In which case the question (as for you) is what is causing ongoing symptoms? I have read that it is possible for a healing liver to cause discomfort if it has been inflamed and swollen. As it gets smaller it can pull on surrounding tissues. Not sure if that theory holds water, but it sounds plausible.

Good luck with your checkup.

[Motik in reply to NieceByMarriage]

Thank you for the information, the pain is less more like discomfort left... But my nausea is bad, especially morning, i barely eat... That's what i forgot to ask you, you mention nausea before, how is it now? I will keep you posted.

[NieceByMarriage in reply to Motik]

I have very slight nausea most mornings. Before treatment it was worse and lasted most of the day. My nausea was (weirdly) relieved by eating but would come back a short time after meals. I became very used to ignoring nausea and getting on with my life, so the slight nausea I have now is not really noticeable unless I pay attention to how I feel.

[Motik in reply to NieceByMarriage]

Hi there,So I had ultrasound, fibroscan an Doppler today, tomorrow i expect gastroscopy. Ultrasound got only gallbladder stones, multiple, fibroscan: 4.2 kpa, CAP 270.. Doppler guy said blood flow is ok, but yet I want to see detailed results.In general i feel less nauseous, way less... Im expecting the gastroscopy so I can finish with this madness.. Doctor didnt say nothing about my ast alt ratio... She said that all bloods are just fine.. I also had HCV pcr, results will be ready in a week. I just need some closure...

[NieceByMarriage in reply to Motik]

That is a comprehensive suite of tests. I hope the gastroscopy goes well. Not sure if you have had one before. I had one (to investigate nausea before they discovered my HCV) and although it was unpleasant it was not as bad as I had feared. My HCV test immediately post-treatment has come back clear so that is good news. My discomfort seems to be abating, too. Maybe it is the gallstones causing your symptoms? I had mine out a couple of years ago. If the gallbladder is unhappy you may be having issues with digestion of fats and that can cause nausea.

[Motik in reply to NieceByMarriage]

Im finally done.. gastroscopy all good (i had 2 before, nothing scary).. little bit of reflux inflammation otherwise my stomach is fine, said the doc. Yes, according to the doc I have to take the gallbladder out, its causing troubles and nausea, she gave me diet plan that I should follow. She also gave me some pills-gastro protectors. I dont feel nausea now .. i took one few hours ago and the nausea went away...So things are clear..