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<blockquote data-quote="Marguerite" data-source="post: 140395" data-attributes="member: 1991"><p>Sorry, something I just remembered - get the doctor to look at your ratio of ALT to AST. If your liver is poisoned (ie by alcohol or other toxins) then the ratio is different, to a liver which is auto-immune-damaged. I'm not sure if this still holds true if your bilirubin is high, though.</p><p></p><p>There is a condition called non-alcoholic steato-hepatitis (NASH). The steato-hepatitis refers to fatty infiltration of the liver. You can get this infiltration as primary (such as a fatty diet, with fat being deposited in the liver) or secondary, with scar tissue forming and fat being deposited in the scar tissue because the body isn't using that bit for anything useful.</p><p></p><p>If the doctor's OFFICE made some remark about alcohol use and it WASN'T in jest, you should be able to make a formal complaint. That is unacceptable (even if it's true). Complain to the GP, make a fuss and ask the doctor what you have to do to conviince him that this is not due to alcohol intake. It's not just your reputation; what is more important, is you want the doctor to have a good understanding of the cause and not get sidetracked by a misunderstanding.</p><p></p><p>If you have a fatty liver due to excessive alcohol intake, that is one thing. But if it is something else and nothing is done about it, then treating the patient as an alcoholic is not going to fix the underlying cause. Tell the doctor. See what he says, before you decide to move on. You could even ask to be referred to someone who is prepared to listen to you and look for more possibilities.</p><p></p><p>I hope you can get some help.</p><p></p><p>Marg</p></blockquote><p></p>
[QUOTE="Marguerite, post: 140395, member: 1991"] Sorry, something I just remembered - get the doctor to look at your ratio of ALT to AST. If your liver is poisoned (ie by alcohol or other toxins) then the ratio is different, to a liver which is auto-immune-damaged. I'm not sure if this still holds true if your bilirubin is high, though. There is a condition called non-alcoholic steato-hepatitis (NASH). The steato-hepatitis refers to fatty infiltration of the liver. You can get this infiltration as primary (such as a fatty diet, with fat being deposited in the liver) or secondary, with scar tissue forming and fat being deposited in the scar tissue because the body isn't using that bit for anything useful. If the doctor's OFFICE made some remark about alcohol use and it WASN'T in jest, you should be able to make a formal complaint. That is unacceptable (even if it's true). Complain to the GP, make a fuss and ask the doctor what you have to do to conviince him that this is not due to alcohol intake. It's not just your reputation; what is more important, is you want the doctor to have a good understanding of the cause and not get sidetracked by a misunderstanding. If you have a fatty liver due to excessive alcohol intake, that is one thing. But if it is something else and nothing is done about it, then treating the patient as an alcoholic is not going to fix the underlying cause. Tell the doctor. See what he says, before you decide to move on. You could even ask to be referred to someone who is prepared to listen to you and look for more possibilities. I hope you can get some help. Marg [/QUOTE]
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