I'm Confused

[KCRoyalsFan]

First, let me state that I am a recovering alcoholic and have been sober for two  years. I have been aware for some time that my drinking and drug use could lead to health complications at some point. That said, I have had lifelong GI issues and started experiencing a lot more painful gas that seemed to be just as painful no matter what I ate. This was back in January of this year. Around the same time my primary doctor ordered some routine lab work and what I see from this is that, at the time, my ALT was at 45 unit/L and my AST was 24 unit/L. The GI DR I began to see did a series of test including an abdominal ultrasound that showed a fatty liver and enlarged spleen. He eventually ordered more blood work which was done last Friday, and when that came back, by ALT was 114 and my AST 62. So the GI doctor calls me yesterday and says he thinks it is cirrhosis caused by alcohol and that he wants me to get another blood test done (which I did this morning).

So here's where my confusion is:
If this is caused by alcohol, why did I not show these elevated enzyme levels when they were measured back in January? Is it possible that it wouldn't show up until over two years after I stop drinking? I'm having a hard time wrapping my head around how it would've happened and it doesn't make a lot of sense to me.

[hvcSVRdudedude]

from my understanding, AST and ALT ratios indicate the source of the damage. With Alcohol derived we might be more likely to see AST= ALT or more higher AST ratio to ALT

[flyinlynn]

Just to add I had hep c and developed cirrhosis because of it. I am now cured of hep c and my ALT is 24 and AST is 22 but is still have cirrhosis. I am an example of a person with cirrhosis and normal ALT/AST. My numbers are now normal because my liver is no longer being injured by the hep c virus.

What kind of doctor are you seeing? Are they a gastroenterologist?

Good luck getting this all sorted out.

[HectorSF]

Congratulations on your sobriety!!!
That is the main step anyone can do to prevent future liver disease and many other conditions and illnesses.

By the way you should know that “painful gas” is NOT a sign of cirrhosis. Your doctor should have told you that.

Fatty liver is a common complication of alcoholic liver disease. You say you have an enlarge spleen? What are your platelet counts? Less than 100,000?

I am not sure why your doctor is confused about whether you have cirrhosis or not. A simple physical exam of your abdomen, ultrasound and lab tests would tell the story one way or another. The Ultrasound report would say it sees a nodular liver with changes in size of portions of the liver plus changes to the surrounding blood supply.
Do you have to report? Please post it.

The main thing is you have stopped drinking it is the only “treatment” for alcoholic cirrhosis and its resulting fatty liver disease” so in time your liver will heal itself. Time meaning over a period of years even if you have or had cirrhosis.

As far as rise in enzymes …you need to repeat the tests. It could be a temporary glitch. Enzyme levels indicate damage being done to your liver now. When you are taking the test. They are NOT used to diagnose cirrhosis. People can have normal enzyme levels and have cirrhosis and vise versa.

Any good doctor can diagnose cirrhosis easily. You shouldn’t need multiple visits. You may want a second opinion if you don’t get to the bottom of this on your next visit.
  
I hope this answers some of you questions.

Hector

[hellolove228]

Hi everyone,I need some advice I am
Chronic hepb female 30yrs, weight 128lbs , 5ft7  . am starting vemlidy next month, have  noncancerous cyst on my kidney, my viral load is 157000.000 ml and fibrosis stage 2 (8.9kp) is it really bad ? Does vemlidy has side effects on any of you ?  Am confuse and just learned about my hepatitis b, hope i can get answers here

[flyinlynn]

Three year old post from 2015 doubtful anyone will see your comment. Ask one new question and wait for an answer or speak with your doctor.