Do I really have a serious liver disease?
Hello. I am twenty years old male 5 foot 6 inches 158.4 pounds. I am a heavy drinker for about three years but the last year I have started drinking everyday about one bottle of whisky or more. I made some tests and found my liver enzymes high. I was diagnosed with fatty liver disease. I cut alcohol completely for twelve days but I had a swelling in my right upper rib next to diaphragm. After these days, I started drinking about two nights per week and then made some blood tests. My liver enzymes were fine but the swelling didn't go away. Now, for about two months I started drinking more than a bottle of whisky everyday and the swelling started spreading all over the upper right side of the abdominal. I thought the liver cannot be swelling over the bone, so I didn't mind until two or three days ago that I noticed my right abdominal is swollen under the ribcage too and have nausea and want to vomit every time I eat or start drinking for about two weeks. I also had right ribcage pains. All these symptoms used to disappear when I was starting getting drunk. I only vomited once though, a day that I started drinking whisky without having eatten anything before. Suddenly, yesterday I woke up with thirteen red spots on my chest and severe lower right and left back pains, pains in the whole right ribcage and pains in the upper left rib. These pains come and go and can be felt only on one spot at a time. They don't last more than ten minutes in each spot. I can also feel my stomach purring too much. The red spots are pin-sized and totally circular without rough edges (not spider-like). Sometimes I have a little itching in these spots too (not the rest of the body). I don't have jaundice and haven't noticed any special tiredness or abnormal weight loss.
It is cirrhosis, right?
Re: Do I really have a serious liver disease?
Hello Normann, and welcome to HealthBoards.
It would be unusual to develop clinical cirrhosis with 3 years of heavy drinking, though not impossible. A biopsy is the only way to tell for sure, but if you live outside the USA, there is a test called "Fibroscan" which can indicate how much trouble you may be in.
Heavy drinking causes a very fatty liver (fatty hepatomegaly) and this is the first stage of alcoholic liver disease. In the second stage, immune cells in the liver (kupffer cells) become inflamed and grow in number (activation and proliferation of kupffer cells). This is called Alcoholic Steatohepatitis.
Alcoholic Steatohepatitis can very easily tip into acute alcoholic hepatitis which is very dangerous and can kill very quickly. This typically occurs after a substantial binge of several days or weeks when you suddenly find yourself unable to eat and very ill. You must keep eating... If you ever find you can no longer eat while drinking at high levels, you must get medical help immediately or you'll run a substantial risk of being dead within a few weeks time. Cirrhosis kills very slowly, but alcoholic hepatitis is very fast and very deadly.
If you survive alcoholic hepatitis, or quit drinking before you have steatohepatitis for too long, many can have a complete recovery and live a long and healthy life so long as they can stay away from alcohol.
You are lucky in that you are young and have only been drinking for a few years... Patients at your stage of alcoholism often can leave alcohol quite easily once they put their mind to it. Older drinkers who have been alcohol dependent for 10 or 20 years, typically have a terrible time leaving alcohol, and often continue relapsing until they develop cirrhosis.
Cirrhosis typically presents with low platelets and albumin, an inverted ALT/AST ratio (AST substantially higher than ALT with both over normal ranges), an inverted albumen/globulin ratio (globulins higher than albumin); a coarse echotexture (liver) and enlarged spleen and portal vein on ultrasound, and usually swelling in the legs and/or abdomen.
I'm not a doctor, but I'd bet your liver is still salvageable... No one can force you to stop drinking, but the best motivation I know of is to find yourself a cirrhosis forum and read about what people with this disease live with day to day and go through trying to stay alive. It's a bad way to go, and though you may not have cirrhosis at this point, it will be very hard to avoid not all that far down the road if you can't get a handle on your drinking now.
If you had substantial withdrawals when you quit drinking before, they can get much worse with subsequent detox episodes and become very dangerous. Seizures and DT's are no fun and they can kill you. If you can not or will not get medical help getting off alcohol soon, switch to beer only, then light beer... Try not to drink during the day. Most dangerous detox symptoms don't start until you are dry for 18 to 24 hours.
If you can get to where you don't drink during the day, start delaying your "start time" with the beer later and later (going to bed at your normal time) until you reach a point where you can quit without serious withdrawals. This can be done! I did it myself!
Best of Luck to you, and GodSpeed.
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