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Posted 5/15/2014 3:05 PM (GMT 0)
I'm worried about my sister.

She's always drank quite heavily, but nothing out of control. She's also got some history of drug use (nothing injected) and recently was taking some meds for other issues.

She's gotten jaundice a bit though her bilirubin results have never been above 1.2. INR was 1.2 and most everything else is in order. Her fibroscan results were .25. ultrasound is fine.

she tells me she the docs say theres nothing wrong but she's hyper reactive to anything, she tells me her stool is sometimes greyey greeny and floaty, then if shes careful about everything she eats etc after a few days it's normal brown. if she exercises then it can inflame that area and her yellowing increases and her poop goes lighter. if she eats a super fatty meal then it reacts and she has a big increase in symptoms.

she thinks theres nothing wrong, but im worried. obv she has quit drinking, but with her docs telling her theres nothing wrong, but then the symptoms she tells me about (along with tingling skin, yellowy eyes around the edges and mild pain under her ribs right side) I would beg to differ. this has been going on for about 6 months now and it seems to be much more hyperreactive than before.

I'm asking here because I want to help her the best I can.... ?
Posted 5/15/2014 3:06 PM (GMT 0)
She's 30 by the way... had a mild episode of much milder jaundice in the past which seemed to go away but she was a drinker for a few years after that
Posted 5/15/2014 3:30 PM (GMT 0)
Welcome, If she does not have Hep C and stops using alcohol forever, she is giving herself the best odd's of living without liver disease. Also, some meds are not liver friendly. Eating what does not cause problems is worth it! She should have a follow-up with a hepatologist if she is concerned. Best to you both
Posted 5/15/2014 5:12 PM (GMT 0)
davey,

Welcome to the forum. There are some good articles and url's at the top of this forum plus a list of our guidlines for posting...give them a look see, maybe you can find more information there.

As themiz has said, it isn't just alcohol and drugs that can cause liver disease...there are several other causes: autoimmune hepatitis (where your own body attacks the liver), reaction to too much TYLENOL can quickly damage a liver, a condition known as hemachromatosis (too much iron in the blood), NASH (non alcholic liver disease often called Fatty Liver Disease), some complications of pregnancy, etc.

Sometimes the problem is complicated and I total agree with themiz...get a follow up with a liver specialist, a hepatologiest. Your PCP or local GI doc has a lot of things to consider and are not totally UP on all the issues with liver disease.

The best hepatology specialists are at major medical centers that do liver transplants. Not that she needs one, but those are the docs on the cutting edge of the research, etc. We have had folks with failing livers where the cause has never been found!!!

You shared her kidney numbers...but don't see her liver function tests: AST/ALT/GGTP. What are those running?

And did they do the cancer marker tests---AFP or ALK PHOS?

I think a hepatologist would call for an abdominal MRI and maybe even a fibroscan or liver biopsy....to be thorough.

I'm glad you are pursuing this. When a person is jaundiced, something isn't right.

themiz mentioned good lifestyle habits as very positive....low fat, low sodium, no alcohol, and for folks with liver disease (if that is the case), have a hard time digesting beef.

Come back any time with questions.

Hugs,
Mama Lama
Posted 5/15/2014 8:17 PM (GMT 0)
Hi Davey - Not much data to work with in your post as indicated by others but seems suspiciously like a transient bile flow obstruction. A bilirubin level of 1.2 isn't high enough to cause jaundice, that would take around 2.5 or so. But a temporary blockage (small stone or sludge) could cause a spike in the bilirubin levels as well as RUQ discomfort and stool issues. The bile flow obstruction may also cause very dark urine since the conjugated portion of the bilirubin will increase and can be passed by the kidney (water soluble) - something she can watch for. Be sure to check her blood count to make sure that she's not anemic, sometimes this causes "pallor" and can be confused with jaundice. Hope things work out well for her and you.
Posted 5/15/2014 8:24 PM (GMT 0)
hey, the only thing that rings a bell is gilberts syndrome. gilberts comes and goes by itself with no liver disease. your fibroscan shows no liver damage and US is clean.

if you could post your other lab tests, it would help
Posted 5/15/2014 8:46 PM (GMT 0)
first of all thanks very much for the replies.

In response to questions.... enzymes were raised a little (around 50-60) a while ago and have been normal since (24/29)

alk 54
dehydtated lact or something - 165
albuymnia 5
glob 2
ggtp 10
nitrogen urea 8 (low)

blood count all in normal range

bilirubin has been about .4 to 1.2 on about 4 occasions... but it must be higher at times because her stool color changes and so i guess it clears out and then jumps at other times.... her hands and feet always have a yellow tone to them

US clean

fibroscan (back in november, she might ask for a new one)

0.23 fibrotest.
0.26 actitest,
0.1 steatotest.
0.22 nashtest,
0.00 ash test
Posted 5/15/2014 8:54 PM (GMT 0)
she looks very well, generally. but she tells me her torso can get sore under right ribs.... like after she had a few day of eating a lot of fatty food on holiday and smoking cigarettes (she promises no alcohol) it was very tender to the touch.

sometimes she complains shes more yellow.... i could clearly notice after these days detailed above on her face

Post Edited (daveypoo) : 5/15/2014 2:57:02 PM (GMT-6)

Posted 5/15/2014 9:29 PM (GMT 0)
Have her see a hepatologist if she continues to have concerns. If her doctor was not concerned in Nov, it is unlikely anything was missed, other than it does seem more like IBS.
Posted 5/16/2014 12:48 AM (GMT 0)
This definitely sounds at the Biliary end of a HPB problem to me.
Posted 5/16/2014 8:07 PM (GMT 0)
any other input guys? Much appreciated :)
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