VERY confused

[WendyMarie]

I was diagnosed 18 months ago with PBC. My gastro Dr. at that time, as well as my hepatologist, told me that I do NOT have fatty liver disease. Now I have a new gastro Dr. She recently told me that I DO have fatty liver disease, in addition to the PBC. My ALT & AST are normal, & that is what I read is the definitive diagnoses for fattly liver disease, along with evidence in the liver ultrasound. My 4 liver ultrasounds show n evidence of FLD. She also tells me she thinks FLD is the main reason my ALP is elevated, rather than the PBC, since my AMA is .33.I don't know what to believe. What would you think, if you were told this?

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Hello WendyMarie.

Well as I understand it fatty liver is a stage of PBC. I say this because I filled out a survery 2yrs ago from a liver charity (sorry I cannot recall which one) and when I clicked I had PBC there were stages for you to click on with it. The first was inflammation as what I was said to have at diagnosis later 2010. The next stage was fatty liver. I know stages of PBC are said to be referred to as numbers but to me stages don't really mean anything. I am certain that if one has fatty liver then the stools are said to be 'fatty' and of a greasy nature.

It is possible for one to know from an ultrasound that you have a fatty liver. I saw a programme on tv 2mths prior to my daignosis in 2010 and was something I'd not have normally seen but for setting a dvd to record a later movie. On the programme which was live at the time, 2 men, one in his 30s and the other in his early 50s both had scans on air. The hepatologist went through their scans as he was undertaking them and pointed out that the man in his 30s who was very overweight had developed a fatty liver. The man in his early 50s who was a very heavy drinker showed that he had hit the cirrhosis stage due to it.

I think I'd be annoyed if I had been told one thing and then another. I had a minor discrepancy myself when I originally saw the gastro for the first time back in later 2010. He rechecked the ultrasound I had whilst I was there and said that he could see my bile ducts, they were looking good and he also said it was looking quite normal. I have had a few run-ins myself with doctors since PBC diagnosis and I know for me my bug-bear at my current surgery where it is a 3 GP practice is that for the last 18mths I've had all 3 check my blood results at different times I've had them and got a bit of confliction that really does annoy me somewhat. The new GP who is a young woman checked my LFTs on their return late last yr and then rang me to tell me my LFts were abnormal! I said they were supposed to be in PBC and she said, 'Higher than the previous ones' to which I then said they were good compared to what they used to be like to which she cofesses she didn't have previous ones in front of her like I did!

What I can only suggest is perhaps to get the doctor to show you the ultrasound results from latest one and go through it. I certainly think that anyone with anything wrong with the liver is liable for abnormal LFTs and I reckon it could be expected with both fatty liver and also PBC as well as others like PSC and NASH.