I “gut” an update!

I got the results of my upper abdomen ultrasound last week so let me start with the good news first. 

I have a normal scan for the gallbladder (no gallstones), kidneys, pancreas, spleen, and abdominal aorta. I heaved a sigh of relief knowing that I won’t need to go under the knife after suspecting gallstones earlier.

However, the bad news is I have what they call Nonalcoholic fatty liver disease (NAFLD). 

As the name itself suggests, it means that my liver has a buildup of extra fat (about 5% - 10% of its weight) which, if untreated, can affect the liver function and cause injury to the organ itself. 

The good thing at least (it’s always good to look at the positive side of things), is that my liver is still within normal size and it’s not inflamed or scarred. I mean, that’s what “no focal lesion seen” means, right? 

My endocrinologist, Dra. Sarmiento, said it’s highly likely because of my high cholesterol levels, LPL, and triglyceride. As per my latest blood chemistry results, I managed to lower it in a month but it’s still higher than the reference values.

When my endo found out that I have a fatty liver, she said that I might already have it long before and only discovered it now. Almost always, fatty liver shows no noticeable symptoms except when it worsens. She also added that this is irreversible (even if, from what I know, the liver can “regenerate” and heal itself unless it’s already cirrhosis). Hearing that there’s no way to get it back to a normal, healthy liver not only bummed me but also scared me quite a bit. I guess this is what they mean when they warn you about how our body starts asking for payback for all the bad habits as we get older. 

She said that since I’m also in my forties, changing my diet or avoiding high-cholesterol foods won’t make the cut anymore and that I have to take maintenance meds already. She prescribed 20 mg. Atorvastatin, which I had to take once a day, to help lower “bad” cholesterol and fats. Fatty liver gave me a higher risk for cardiovascular diseases like stroke and heart attack.

(I know, right? Telling me in my early twenties that I’ll end up having this in my forties and I would have laughed straight at your face. Especially when I grew up thinking that such a disease is only for the obese).

Again, I still have to avoid fatty and high-cholesterol food as much as I could and eat more fruits and vegetables, which is why for two days now, all I’ve been eating are sardines and tuna.

Meanwhile, my immunology results show that my TSH (thyroid-stimulating hormone) levels went down from 4.180 to 1.290mlU/L after changing the dosage of my thyroid replacement meds, which is great. At least that visit to the endo last Friday gave me some good news too.

Since I’m still having that strange pain around the stomach after seeing an internal medicine doctor two weeks ago, I visited a gastroenterologist the next day, Saturday. From her, I found out that a fatty liver itself doesn’t cause any pain even if I’m feeling something on the upper right side of the abdomen where it’s located. If that’s the case, then why do I have this dull ache around my lower ribs? 

After a series of questioning and pressing areas of my abdomen while lying down (to check what areas hurt), Dra. Mercado said that I might have a combination of acid and dyspepsia. Dyspepsia or indigestion is more of a symptom than a disease; possibly my digestive system isn’t functioning just as it should. This is why I feel full, bloated and with so much discomfort especially after eating like nothing is moving down. She also suspected that my thyroid issue might have played a role because thyroid and gut health has a strong correlation. 

And so I was given a medicine (Domperidone + Pantoprazole) which I have to take for two weeks. If nothing happens by then (meaning if I still feel pain in the area), then she will have to require an endoscopy to see if there’s a more serious cause of the pain that can’t be seen through blood tests and ultrasound. 

I’m praying that the pain goes away because I don’t want it to be something else, especially something more sinister. I mean, I no longer feel the tightening of the chest or burning sensation on my stomach (which suggests acid) but the bloating, fullness, and ache are still there and it’s been what—almost a month since I first had it? 

Hippocrates himself said that “all disease begins in the gut” and it might be something that was said millennia ago but has some truth to it. 

Meanwhile, all of these left me having to take four types of medications in a day. Ain’t that bad for the liver too?