Brief Answer:
It's very likely you have liver damage

Detailed Answer:
Hi, thank you for using Healthcare Magic. Your drinking history suggests the probability that you have some resultant liver damage. There is no way to know the extent of it without testing. The only thing I can say is that if you continue drinking, it will definitely progress to liver failure sooner or later. There is no way to know without testing whether you have reached the point of no return by now.

Ascites is the end result of advanced liver cirrhosis. There is no way to know if you have ascites without at the minimum having your abdomen looked at. You would probably need further testing then as well.

Your lack of other symptoms does not rule out the presence of liver damage. Cirrhosis can be far advanced before signs and symptoms appear. In fact, the appearance of signs such as ascites is evidence that the cirrhosis has advanced into liver failure, at which point little can be done.

Recently, I had a friend die of complications related to chronic hepatitis C, which along with alcoholism is the leading cause of liver cirrhosis and failure. My friend had absolutely no physical evidence for cirrhosis until the day his abdomen swelled up from ascites. 2 months later he was dead from liver failure. I use this as an example similar to your situation. You could have advanced cirrhosis at this time and not know it until it becomes obvious with the appearance of ascites or gastrointestinal bleeding.

I understand your concern about lack of funds, but if you are concerned about your health, you will have to get testing. Hopefully it will be early enough that something can be done to help prevent progression. If you continue drinking, you can guarantee yourself that it's only a matter of time before physical evidence of cirrhosis such as ascites will present itself (if you don't have it already).

Please let me know if you have further questions.

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Brief Answer:
Ascites can be controlled by medication

Detailed Answer:
If you have ascites from cirrhosis related to drinking, the cirrhosis is not reversible at this point. The ascites can be controlled with medication and other means such as surgically placed shunts. Stopping drinking will prevent further liver damage but will not reverse the damage already done.

The ascites therefore could be "reversed" (ie, the swelling could go away) with treatment, but the underlying condition causing it (the cirrhosis) is not reversible. The only thing you can do is prevent further progression by stopping the alcohol. If you stop drinking, it is possible the ascites may improve some on its own, but the underlying condition will not. The ascites is mainly just a sign your liver is struggling. You can help your liver and prolong your life by stopping drinking now.

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Brief Answer:
The small weight variations are probably not significant

Detailed Answer:
Hi,

Weight normally varies a little from day to day, and even at different times during the day. This has to do with differences in water and salt retention. In chronic water retaining conditions like ascites or congestive heart failure, daily weight can give an idea of how well treatment is working to get rid of the excess water. In those cases, a weight gain of 2 pounds in 3 days may be an indication the treatment is somewhat inadequate.

In advanced liver disease, weight LOSS occurs because of poor metabolism and loss of muscle mass. Water retention with ascites may balance the weight out since water is pretty heavy, but the lean body weight is decreased. Very advanced liver disease patients may have a large abdomen due to ascites, but very thin extremities and face.

So you can't say that weight gain per se is a sign of liver malfunction, nor can you determine its presence on the basis of weight gain. The weight changes you mention I would not consider excessive. They fall within the range of normal variations and cannot be used to judge whether you have liver failure or not. If you started losing a lot of weight without trying, that actually would be more of an indication of serious illness.

Regards,

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Brief Answer:
The liver damage is not reversible

Detailed Answer:
Hi,

By the time ascites shows up, the liver damage is advanced and not reversible. Ascites is mainly a symptom of advanced liver disease. Stopping drinking will not reverse the damage that has already occurred. It will stop the progression of the liver disease. It is possible that some resolution of the physical signs of the ascites (fluid decrease) may occur with stopping the alcohol, but whatever damage has already occurred in the liver will not. Cirrhosis is actual scarring and can't change. Depending on how many viable liver cells remain, the cessation of alcohol will allow those cells to continue doing their job and maybe regenerate a little. This can prolong life. Continuing to drink will cause damage to the remaining cells so that complete liver failure will occur.

You don't know for sure if you have ascites without getting checked. Whether you have it or not, your only option to prolong life is to quit drinking. Hopefully you have enough remaining functional liver at this time that your survival will be minimally affected. But your continuing to drink will guarantee an earlier death.

Regards,

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