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Fatty liver treatment - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Liver and Gall Bladder
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
Doctor :   Hi,
User :   Hello.
User :   Nice to meet you.
Doctor :   Nice to meet you too
User :   Do I need to retype my original question, or do you already have it. I'm a first time user.
Doctor :   No i do not see the question , please retype
User :   I just had an ultrasound of the abdomen. It revealed a "fatty liver" with no focal mass. My ast/alt were recently slightly elevated (10 and 30 points higher), but most recent blood test last weeks shows ast/alt back in normal ranges. However, the ultrasound also showed a "slightly enlarged spleen." 14.3 cm. Are these related? I'm a 33 y.o. male, 200 lbs. (i was 220 lbs. two months ago, but thanks to anxiety and better eating habits, have lost weight). My primary doctor didn't seem to concerned about liver (told me to eat better, lose weight, and quit drinking...i quit drinking months ago...and had drank regularly for many years). He didn't even mention the spleen. I guess I'm just worried. Thanks.
Doctor :   Let me read it
User :   I'm also going to see a gastro soon for this, but also, because of recent change in bowel habits. I've been taking lorezepam for anxiety off and on for the last two months.
Doctor :   Fatty liver is seen commonly due to alcohol consumption for long term
Doctor :   ast and alt are the enzymes present in the liver any functional or structural damage to the liver will show elevation in their values
Doctor :   the better to determine alcohol induced fatty liver / liver damage would be by GGT
Doctor :   Gama Glutamyl Transpeptidase
Doctor :   and yes spleenomegaly ( enlarged spleen )is related to liver pathology
Doctor :   as the blood pressure which is raised in the liver due to swelling affects the pressure in the spleen too leading to congestion and swelling
Doctor :   the splenic vein drains into the hepatic vein hence the pressure from the swollen liver is transmitted to the spleen
User :   also note that my cbc blood tests are in normal ranges, as it would pertain to red blood and white blood cells.
Doctor :   CBC is about the RBCs and WBCs and not directly related to the liver problem
User :   i guess i mentioned that as related to spleen.
Doctor :   also the overweight and faulty techniques /sudden weight loss adds to the fatty liver
User :   is the spleen that bad? 14 cm?
User :   i've read in some places that that is still considered in normal range.
Doctor :   yes, its ok for the spleen to be 14 cm
Doctor :   11 to 14 would be the range
User :   oh ok. because a lot of places also say that anything more than 12 is bad. but most likely they aren't doctors!
User :   google can be a dangerous thing.
Doctor :   but it also depends on the cause of the spleenomegaly
User :   i'm also on antibiotics (zithromax) for a chronic sinus infection, don't know if that has anything to do with it.
Doctor :   no, i do not think it adds to the plemrob
Doctor :   problem*
User :   i'm thinking my primary doctor didn't even mention the spleen issue from the report because he probably figured it related to the liver issue.
Doctor :   yes,
User :   and, the spleen didn't say anything about any focal masses, etc.
User :   *spleen portion of ultrasound report
Doctor :   ok, thats clear
Doctor :   ruling out other causes of spleenomegaly
User :   what does that rule out?
Doctor :   the absence of masses rules out causes like cysts or tumors
User :   good.
User :   do you think i will need any further testing on the spleen, or should i monitor it along with the liver?
User :   i guess i'm asking what recommendations you have?
User :   i'm definitely going to a gastro.
User :   not sure what they might do.
Doctor :   no the USG is the gold standard for the spleen
User :   USG?
User :   oh, ultrasound. got it.
Doctor :   yes,
User :   i guess i meant to figure out what is causing the "slight enlargement" or if just wait and see if the fatty liver gets better, should make the spleen "smaller."
User :   and, gotta ask because it's in the back of mind, lymphoma unlikely? no lymph nodes swollen at present that i'm aware of.
Doctor :   yes, i would consider it a clear possibility , when the fatty liver gets resolved the spleen should get better
User :   i think that's the anxiety talking.
User :   given the slight enlargement i think it's tied to the liver issue.
User :   and not something else.
Doctor :   yes, i can be sure of it
Doctor :   liver is the culprit
User :   thank you doctor.
Doctor :   Thanks for consulting me , kindly provide your feedbck
Doctor :   Bye for now
User :   you were awesome.
Doctor :   take care
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