Now liver problems and decisions?

I have recently developed some worrisome symptoms in my liver (liver enzymes elevated and cysts in liver). I have been on Lialda and Canasa since dx almost 2 years ago. When they discovered pseudopolyps at my last colonoscopy, my regular GI doc recommended changing meds (changing to Imuran) or possible removal of my colon. Then the specialist I saw at UCSF said the Imuran would be harder on my liver and has recommended more tests and referral to a Hepatologist. I am now in the middle of a severe flare that has caused me to drop almost 7 lbs in a week (I had already lost almost 30 lbs since dx). It appears that I need to change my meds, but every med that helps UC affects the liver - right? I have the tests scheduled for this Friday and I know it will take me awhile to get in to see the Hepatologist, I don't know what to do to feel better now.

This is a tricky business.

Imuran will be hard on liver for sure but the hepatologist has to figure out the cause. I don't think Lialda can be the cause. If you have been on Prednisone for a while, it also messes up with the liver, at the same time, CAT scan or similar will show fatty liver, because of prednisone.

I can not comment on cyst because AFAIK, this is the first time I am reading this here, so there can be something else. Not necessarily this cyst is of concern. My BIL had it few months ago out of blue moon, perfectly healthy guy. It took about 2 months and now he is fine.

Dropping weight is not a big deal, unless you are on lighter side to begin with. You don't seem to have enough experience with weight fluctuations but this is commonplace in this world. Majority of us have different size clothing. You will be fine once your flare is in control.

If you HAVE to go by Imuran route, make sure to test your CBC, liver function and lipid profile before every increase in dose. It will be increased in the steps of 25mg

I was worried about liver busting when I started Imuran and also had an hepatologist on board. He assured me that the liver is lot stronger than we think.
If you are fond of alcohol, may be it is good idea to say bye bye, save money and keep liver healthy.

I would
- talk to hepatologist and get all tests done. See where it goes
- If you have latest colonoscopy report, check where and how much is the inflammation
- What drugs you have tried and what else is left for you, before you go on biologics or under the knife. Study those drugs, read experiences here and discuss it with your GI/hepatologist.

Thanks everyone...right now I have Diarrhea (20 trips to toilet during day & night), Blood in stool, lots of gas, and now vomiting and low grade fever. I am not a big drinker but I do like to have a glass of red wine with dinner when I am not flaring.

The only meds so far are the Lialda and Canasa and a 6 month of Prednisone (& taper) during last flare a year ago.

I do not know how long till I see the Hepatologist (waiting for the referral).

Kazbern - I am looking at my latest colonoscopy and don't know how to answer your question about the amount of inflammation

I find this forum so helpful in putting my symptoms in perspective and the valuable info it contains.

If you haven't been tested yet then you should get tested for a bacteria infection in your Colon, stool samples.... symptoms mimics a UC flare but sometimes it compounds your symptoms of the uc flare (gas, 20+bms a day, vomiting and fever can sometimes be signs of an infection).

The 2 times that I had elevated Liver Enzymes I had bacteria infections both times during my flares.

Post Edited (ks1905) : 9/25/2013 12:24:01 PM (GMT-6)