I get abdominal distension and persistent diarrhea with high ALT and AST values. What is my problem?

Question

Hi doctor,

I am 49 years old and I have been drinking approximately 350 ml of vodka every day for approximately 10-15 years. I also have smoked half pack a day for 30 years but just recently quit. For the past year and a half (maybe even two years) I have had diarrhea daily. I went to a doctor who prescribed IBS medicine and B12 shots, but nothing changed. My stomach is large, distended, and hard. When I eat half a sandwich or six bites of salad, I am so bloated I cannot move. I feel a dull bruise like pain (very dull) in my lower right quadrant from time to time maybe once every two weeks.

My AST and ALT levels are high (112 and 113), glucose is 116, absolute eosinophils are 720H. I have attached my lab reports. My guess is, this is liver disease, pancreas disease, or diabetes. Any ideas? Do I have to quit drinking? Or can I cut back?

I am currently taking Stelara for psoriasis.

Answer 1

Hello,

Welcome to icliniq.com.

I think there are multiple issues. You need proper workup. Your ALT (alanine transaminase) / AST (aspartate transaminase) are due to alcohol-related liver disease, better is to do USG (ultrasound) abdomen.

Other issues are, I had gone through your blood reports (attachment removed to protect patient identity). Your hemoglobin and hematocrit are in range of polycythemia vera which is a blood coagulation disorder. So what is feel is you need a good doctor hematologist for polycythemia and related to your gastric issues.

USG abdomen and endoscopy with biopsy can be done if possible, as this will tell us liver and pancreas status as alcohol affects both. Second thing, stop smoking which is a culprit for your high Hb so to get that worked up there are series of tests need to be done. My advice is to choose a good doctor to get everything thing done.