Ultrasound confirms I have fatty liver deposits, enlarged liver & gallstones. I need some advice.

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Here is my Ultrasound report 

"Report Status: Verified Date Reported: MAR 28, 2018

Date Verified: MAR 28, 2018

Report: Abdominal ultrasound.

History: Elevated transaminases.

Comparison: None.

Findings: Visualized portion of the pancreas is normal. The liver is mildly enlarged in size measuring 17 cm. The liver is mildly echogenic diffusely. No mass, intra-or extrahepatic biliary ductal dilation in the visualized liver. The common bile duct is normal in size measuring 0.5cm. There are intraluminal gallstones, no acute cholecystitis. The portal vein has normal direction of flow and waveform. The hepatic veins have normal direction of flow. Visualized inferior vena cava is patent. Incompletely evaluated aorta is without abnormality. No ascites is seen. Right kidney is normal in size and echogenicity. No hydronephrosis.

Impression: 1. Hepatic steatosis, mild hepatomegaly and cholelithiasis."

My blood test levels as of 4 January 2017

ALT 73 U/L H

AST 42 U/L H 

LDL DIRECT 159 mg/dL

CHOLESTEROL 237 mg/dL H

UREA NITROGEN 21 mg/dL H

I am due for another blood test in about a week. 

About me:

I am 27, 6ft 2inch, 230 pounds(was probably 237 at blood test). I was in the Army from 2010 to June 2015. In 2016 my Cholesterol was 201, LDL 121, ALT 27, and AST 21. Since being out of the Army I have infrequently excersised, drink alot more, and have had a very poor diet of fast food almost every lunch. Drinking alcohol in 2017 especially over the summer and in to the new year was very elevated. I could clear a fifth of whiskey in a weekend no problem. I stopped drinking after new years because my side hurt(probably the gallstones) and because I knew I had a blood test coming up that probably wasnt going to look good. I cut out whiskey after seeing my liver levels. And have now cut out any alcohol consumption after finding out about my fatty liver and gallstones. I drank alot but I did not really realize how much it was untill I quit. In the new year 2018 I've had very limited alcohol intake and like I said it is now none.

I am worried that I have severely damaged my body. Here is my doctors letter:

"The following test results will require attention or follow up: 

Ultrasound 

Comment: The liver demonstrates fatty deposits and the gallbladder

demonstrates stones 

Plan/Recommendation: 

Based on your results, I recommend the following: 

Weight loss is the treatment for fatty liver (10-15% of body

weight). Gallstones, assuming asymptomatic, can be treated

conservatively meaning watching for signs and symptoms to suggest

an acute gallbladder attack such as abdominal pain, fevers, nausea

or vomiting with meals particularly of the fatty type. If you do

happen to develop any of these symptoms you should be seen 

immediately. 

Sincerely,"

I have requested a specialist consult on the removal of the gallbladder because I do feel pain like a constant dull/sore/tight 1 maybe 2? Occasionally sometimes it is a sharp maybe 5? Although this could be due to a slightly enlarged liver?

What I wanted advice on is how high to someones liver levels look who has entered cirrhosis? I believe the ultrasound results would have stated they found cirrhosis if I had it correct? Well can they see that on an ultrasound?

I have no symptoms other then a fat belly and some pain. I am working on diet and exercise to drop down to 205 and I plan on never drinking alcohol again. I am currently not on any meds. 

What do you guys think about my condition?

Thank you so much for the help in advance!!!

 

0 likes, 1 reply

1 Reply

  • Posted

    Hi Joshua, & 27 would be a very young age to develop advanced alcoholic disease.  Most (male) chronic heavy drinkers who do go on to advanced disease are diagnosed in their 50s.  

    When it comes to liver labs indicating advanced disease, it is often not how high they go.  Viral hepatitis-A can spike liver enzymes into the thousands, yet most recover from Hep-A without developing cirrhosis.  

    With alcoholic cirrhosis, the AST enzyme typically floats over the ALT enzyme in a classic 2:1 "De Ritis" inversion.  You don't have this, so this is certainly optimistic.  

    A fatty liver shows up as a bright echo on ultrasound, and this can obscure the subtle "coarse" echo that indicates fibrosis/cirrhosis.  If ultrasound is going to detect fibrosis/cirrhosis, it would be best to have a followup scan once that alcohol related fat has been resolved.  Normal portal vein flow is optimistic.  

    Fatty liver can stretch the capsule (Glisson's Capsule) surrounding the liver, producing that dull ache.  Gallstones that cause acute blockage usually are quite painful and occur after eating fatty meals.  I wouldn't be too eager to have my gallbladder out if I'd never had an acute attack.  If the stones are small, they may pass on their own.  

    You should have a remarkable and smooth recovery if you can keep clean.  

    Best Wishes for Better Health!  

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