Fatty liver and pancreas but GP said your scan is normal?

Digestive health
1

Im confused can someone explain please 

Ive had a pain in my right lower chest area going through to my back and it  comes and goes but sometimes its stabbing making me scream unexpectedly mainly at night .

if i sit or lay down it comes on but is less if I stand up?

its been like it for 2months .

i had a chest xray and all is clear so its not broken ribs

I used to have Pancreas insuffiency but then they say i didnt? 

So i came off creon 8 years ago

my GP got me a quick ultrasound.the report came back that afternoon on my patient acess web page 

(which i must stress please everyone sign up to uk patient access? Web site Go to your GP and get a user ID number to view all your medical history for free) you can see letters &results from doctors consultants etc days before the GP Reads it or it comes in the post)

anyways the report said

The liver could not be adequately assessed due the scan restrictions and due to increased echogenecity throughout.

Appearances were of diffuse fatty infiltration.

In the areas seen there is no obvious intrahepatic duct dilation.

The gall bladder was partially obscured.

However,it appeared thin walled and didn't contain calculi.

The CBD was not dilated measuring 5.2mm.

The Pancreas was bright in appearance .

Appearances were of fatty infiltration.

No ascites seen.

i went to my GP next day and he said my scan was normal and didnt suggest diet or reducing alcohol or more exercise?

i said the letter said fatty liver etc and could i have a proper scan as she was young and didnt scan me sitting up or bending over which is why she couldnt access all of my bits properly?

and he said no need your fine go home 

i asked about the pain he said take paracetamol? 

Which i said didn't work 

what shal i do people?

many thanks 

2

Abdominal ultrasounds are usually done lying down on your back and then turning on your side to do the kidneys, but you don't get off the table or move much.

This in my mind is the cop out.

"The liver could not be adequately assessed due the scan restrictions and due to increased echogenicity throughout."

Ultrasounds are only as good as the person doing them. They may be done by a radiologist (a doctor) or a radiographer (a technician). It is pointing to fatty liver, but there could be more and the person who has done the scan is basically saying 'yeah I can see it's fatty but I can't see properly so I shan't comment'

As you have a fatty liver, it is probably increased in size and the liver is probably rubbing on the nerve endings of something else which is causing the pain. Which is why it is better when you are standing up, as the internal organs have most room, as opposed to sitting down when your stomach area becomes more cramped.

Fatty liver is not something to be ignored, on its own, it is not something to be too worried about, left untreated and it can get worse and go on to become fibrosis or worse. My advice (I am not a doctor) is change your eating habits, do not by takeaways, make fresh food i.e. home cooking, no boxed food that goes in the oven or microwave and lose weight if your are overweight. I am assuming that you are not a heavy alcohol drinker, because that will also cause fatty liver.

Personally I would go for a second opinion, I have done this myself. Print off the notes and go to a walk in centre. Just Google NHS walk in centre, you will have to travel to a city because that's where they all are located. Just tell them you are not happy with what your GP has said and you need a second opinion. Tell them that two things bother you, one that you have been told that whilst fatty liver is not serious, it can become serious if ignored which is what your GP is doing. And also about the pains and it has been mentioned to you that the likely cause is an enlarged liver, but whatever it is, a standard painkiller is not doing the trick.

PS all the other stuff you typed from the report is pretty much saying nothing to worry about.

3

My primary care Dr told me the same thing, don't worry mean while I am in pain and showing signs of cirrhosis. I am 35 years old and do not drink. My ultra sound report said I "diffuse increased echogenicity of the liver suggesting hepatocelluar disease likely caused by fatty liver... I had a ct scan prior to the ultrasound without contrast and it said my liver was enlarged measuring 20cm. I am in very bad pain on my right side rib area and I can also feel it in my back. The pain is constant and never goes away and becomes worse every day.

Fyi Tylenol is bad for the liver.. If you have fatty liver you need to eat right and exercise. Fatty liver is not harmless, it can progress into fibrosis and then cirhossis. I finally after over 2 months of waiting saw the gastro 2 months ago and she says I'm showing signs of cirrhosis and has set me up for an endoscopy and an MRI of my liver... I also had a bunch of labs done for my liver. I have been waiting to see the liver specialist and finally my appt is coming next week on the 25th..

If I were you I would see a specialist. It's been my exp primary care Drs don't know very much about the liver. I showed my Dr all the things popping up on my skin which are obivous signs and he brushed them off. He couldn't even tell me what hepatocelluar disease is...

Don't ignore the results and don't let your Dr push you off.

4

' I finally after over 2 months of waiting saw the gastro 2 months ago and she says I'm showing signs of cirrhosis and has set me up for an endoscopy and an MRI of my liver... I also had a bunch of labs done for my liver. I have been waiting to see the liver specialist and finally my appt is coming next week on the 25th..'

Hello stranger, sorry about the cirrhosis, but glad that you got people to take you seriously.

5

I meant to say saw the gastro 2 days ago...

How are you doing??

6

I think RHGB is offering you sound advice.  A fatty liver can be reversed by eating a low fat diet, getting some exercise and losing weight if you are overweight. Also if you drink, cut out alcohol. If you don't eat healthily, exercise and get down to a healthy BMI, you are heading for serious illness which may not be reversible. It's a sad fact that most people in UK eat far more than their needs. I always felt I ate healthily, but after some serious gallbladder issues, I realise I was eating much larger portions than I needed. I have lost about four stones in a year by weighing food, counting calories and eating a low fat diet. 

Your GP sounds like he's not interested. Do as  RHGB says and get a second opinion and ask what you can do to reverses this situation.

7

Oh I'm fine, but I'm not the one who got a bit of a shock from their gastro a few days ago.

8

I am not fine sad I am pretty depressed actually.. I had a lot of blood work done for my liver on Wed including a tumor marker test.. I'm waiting to hear results. I will have endoscopy on the 28th and MRI on the 29th. She said I will also need a biopsy. I have an appt with heptaologist on the 25th...

9

Try to stay positive. Even if it's a worst case scenario and you need liver surgery they can remove large portions of liver these days and the liver regenerates itself quickly. I had liver resection (section 5) in March due to them finding a growth when they removed my gallbladder (gallstones and blocked common bile duct). I am doing well apart from feeling tired a lot and some tenderness where my gallbladder was. In some ways I haven't felt this well in years.

Hope all goes well for you.

10

Thank you for the encouragement ♡ I am trying to stay positive but to be honest I am scared ********... I haven't been feeling well for months now and my Dr just brushed me off even when I went to his office when both my palms turned red and showed him the weird angionomas that were popping up. He told me to go to the dermatologist!!!! Dermatologist sent me right back to dr and told me to tell him to check my liver because I had skin symptoms of end stage liver disease. Now it appears my skin has become transparent and I can see all my veins where I could never see them before.. i am unsure if it's related or not.. I keep getting dizzy and lightheaded, I have no energy and I have lost over 25 pounds since the 25th of July. Everyday I drop a pound or 2. I don't even know how that's possible and the Palmer erythmea on my palms has gotten worse. I am very upset that the wait to see the specialist has been over 2 months. I pray when it's all said and done there is something they can do as I am a mom of 3 and my baby just turned 3 on the 16th. I can't imagine leaving my kids alone in this world just yet.

11

Also I am having serious pain on my right side, right side of abdomen and on the right side of my back on the same level. It's constant and hasn't went away even for 30 seconds since it showed up a few weeks ago. I have to carry the heating pad around...

12

Chin up girl. At least you are getting to the bottom of this now and you have the right people seeing you. They did a cancer marker test on me and didn't even have the decency to tell me, I only found out by accident. If you have the slightest gag reflex, like trouble swallowing a large pill, then make sure you have the sedative for your endoscopy. MRI is nothing and write down a list of questions for the hepatologist, otherwise you will forget.

The biopsy can be painful for a day or so afterwards, so make sure you don't have anything rigorous booked after that. Keep us updated, don't run off.

13

Yeah they don't give you the option to be awake or asleep... they told me they out everyone out here... I have had many MRIS. They have to give me q shot or I panic but it's okay.. I am a little nervous about the contrast though.

14

It's natural to be worried and scared but as someone else said, they are slowly getting to the bottom of things.

The rh sided pain you mention might just be a gallbladder issue.  Gallbladder affects the liver - I developed bad jaundice. Have you had nausea, sickness or diarrhoea recently? I also was tired, had night sweats and suffered loss of appetite before I started having attacks. You do say you've felt unwell for some time. These symptoms were so vague, I felt I couldn't bother my doctor. 

Ive had two ERCPs. They are unpleasant and uncomfortable but not painful and they do sedate you which does help to calm you.

Have you considered presenting yourself at A&E? Maybe then the doctors there will see you are an urgent case and need to be sorted quickly. For the sake of your kids don't hang about. Your doctor sounds useless and it's not him having these issues so he doesn't seem to care. You need to push to get them to do something and that's hard  to do when you've no energy.

I'm not a particularly religious person but I'm praying that all goes well for you. Worry does nothing to help- it just make you feel worse and can cause the weight loss you mention. I've got my first post cancer checkup soon and I've made my mind up to carry on as normal and not think about it too much. I have two daughters but they're adults with children of their own so I'm not in your situation with young children to worry about.

Please keep posting x

15

My gallbladder was removed in 2010 so it can't be that...

I have went to the emergency room but they didn't do much of anything. Maybe I will try again.

16

They told me they wouldn't sedate me for my endoscopy as I was on my own. I had the throat spray but the tube kept banging on the back of my throat as it went down and I kept vomiting bile which they sucked out like at the dentist.

17

Yes, you do need someone to come with you, which I had.

18

Hi sorry to hear of your problems my pain is in the same side as yours and i was wondering have you tried a tens machine for the pain ? You can get them cheap from lloyds chemist .hope things get sorted for you ok

19

Thanks for the info.

when I mentioned different positions for the ultrasound i was refferring to my pancreas to scan the tail of the pancreas as its hard to see without different positions?

I asked the GP about fibrosis etc and hemochromatosis (as my serum ferritin is creeping up higher and higher)and i have heart problems diabetes bone problems etc also being tired etc and he looked bemused at my knowledge and said even some GP's dont know about hemochromatosis 

Realising I wasn't gona give up he refferred me to a gastroman in 3 weeks

also ordered blood tests for vitamins and iron 

i wait to see what happens but im dreading an endoscopy because last time a trainee didnt spray enough numb spray down my throat and took 6 Way too big biopsies that i hemmoraged choking on blood out my throat while they held me down when I said stop? I thought i was going to suffocate?

that night i was back in hospital with internal bleeding?

 

20

It is good that you are going to see a gastro. Haemochromatosis is quite serious and can become very serious if left untreated. There is a very good forum here for haemochormatosis, well worth joining, plenty of very knowledgeable people on there. I joined because at one time my levels were through the roof and my gastro thought that I might have it.

My endoscopies have always been under anaesthetic (as an inpatient) or sedation (outpatient). My gastro is the person that actually does mine and I tell him I have an awful gag reflex and it will end badly, so he gives me enough sedative that I'm out like a light. I'd always advise someone to take a friend/relative and have the sedation.