This post is going to be hard for me due to the fact that I know a lot of people will be judging me. But if I’m going to tell my story, I have to tell it all.
One day, I noticed my abdomen was larger than normal. It was starting to look like I was 5 months pregnant. I joked to the nurse about it, who suggested I talk to my nephrologist. After our discussion, my nephrologist referred me to a gastroenterologist. These types of doctors are trained to diagnose, treat, and manage a variety of conditions that affect the gastrointestinal (GI) tract, such as the stomach, intestines, liver, pancreas, and gallbladder.
There’s a stigma that you can only get cirrhosis of the liver by drinking too much alcohol. Cirrhosis is the scarring of the liver that develops when the liver is trying to heal itself. Several studies have shown that there are other ways to develop cirrhosis.
First, a quick summary of what the liver’s main job is. The liver filters everything that goes into your body. It clears drugs, alcohol, and chemicals out of your blood. The liver then processes the toxins for you to flush out through urine. When too much scar tissue builds up, it can prevent the liver from removing toxins as well as a healthy liver can. This condition is called cirrhosis.
Here are a list of other ways a person may develop cirrhosis
NAFLD – Nonalcoholic Fatty Liver Disease
Caused by built-up fat in the liver. The buildup can cause inflammation and damage, which can lead to scarring of the liver.
Type 2 diabetes – Poorly or uncontrolled diabetes
Uncontrolled diabetes can cause changes to the liver that can lead to metabolic dysfunction-associated steatotic liver disease (MASLD), cirrhosis, and liver cancer. MASLD, a fatty liver disease associated with metabolic syndrome, is one of the most common causes of chronic liver disease.
Certain drugs (prescribed, store bought, and illegal)
Overuse of certain drugs and drugs taken with alcohol can damage liver cells directly and/or block the flow of bile out of the liver. Common OTCs (over-the-counter) include NSAIDs and acetaminophen. Prescriptions include antibiotics, statins, and steroids.
Hepatitis B and C virus infections
Hepatitis B and C are the leading causes of liver cirrhosis in the United States. They are known as silent killers because the diseases develop very slowly over many years. They are common blood-borne viral infections that primarily affect the liver.
Stress
Stress causes our bodies to create large amounts of stress hormones like cortisol. Cortisol can cause inflammation and oxidative stress in the liver. In addition, stress can lead to unhealthy behaviors, including alcohol intake, tobacco use, and poor diet, which are also associated with fatty liver.
Genetic disease
Cystic fibrosis and Wilson disease are just a couple of genetic diseases that can cause cirrhosis of the liver.
It would be noteworthy to mention that women are at a higher risk of developing cirrhosis than their male counterparts, even when they don’t drink or drink as much. According to the Cleveland Clinic, a couple of the reasons are:
- Body size and composition. Women are smaller and have more body fat, which causes them to metabolize drugs and alcohol differently and at a slower rate than men. Women are also more susceptible to liver damage from alcohol due to our differences. We also need to be cautious with certain medications, like pain medications, antibiotics, or, as mentioned, OTC medications. Whether prescribed or store-bought and taken in excessive amounts, women are much more likely to have toxicity from drugs than men.
- Immune reactivity. This is the way the body defends itself against harmful or foreign substances. Differences in immune reactivity between the sexes may also play a part in women’s greater susceptibility to liver damage from drugs and alcohol.
Studies have shown that consumption of one drink per day increases the risk of liver cirrhosis in women but not in men.
Ok, class is over. Now back to my story. I was referred to a gastroenterologist. During the initial examination and consultation, we talked about things going on in my life and what caused my ESRD. I told him about my stress, high blood pressure, and oh, yeah, diabetes.
I always thought I had prediabetes (still serious, don’t let the pre fool ya), which meant my blood sugar was elevated but not enough to be diagnosed with type 2 diabetes. It just required me to watch my diet, exercise, and get plenty of sleep. While researching my medical history for my website I discovered I did have type 2 diabetes; it just fluctuated throughout the years.
A1C levels can fluctuation because of several factors:
- Misdiagnosed – Sometimes the A1C and the blood glucose have different results.
- Supplement regiment.
- Major life events – Stress.
- Iron deficiency anemia.
- Lack of sleep – I mention in an earlier post that this was one of my issues.
- Medications .
Depending on what was going on in my life at the time, my tests could show prediabetes or type 2. It was confusing because I had no primary care doctor and no regular checkups. So each doctor I got in to see told me a different diagnosis.
Sorry, I digressed. Anyway, the gastroenterologist told me that I had cirrhosis, which caused ascites (fluid in the abdomen), and it needed to be removed. The procedure to remove extra fluid from the abdomen is called a paracentesis. The doctor removed 1.75 liters of fluid from my abdomen. I was awake for the procedure, and it took about 30 minutes.
Paracentesis is a procedure performed in patients with ascites, during which a needle is inserted into the peritoneal cavity to obtain ascitic fluid. A sterile cup is used to collect the fluid sample. The fluid is removed and tested to diagnose the cause of ascites or to rule out an infection of peritoneal fluid.
Yes, I did drink, but not enough to cause cirrhosis on its own. There were a lot of things going on during that time in my life, and I just wasn’t paying attention to my health and well-being.
I used to get very bad sinus headaches, so I would take a certain sinus medication often. I’m not going to name it, but like many of them, it contained acetaminophen. What I didn’t care about at the time was that taking too much acetaminophen can damage your liver. Taking acetaminophen with alcohol can cause liver disease. With the stress, diabetes, and alcohol coupled with the acetaminophen, it’s no wonder why my liver developed cirrhosis.
I’m not making excuses for what or how this happened to my liver. I just want others to be careful with drinking, taking medications, and their overall health. Don’t let stress and anxiety consume you so much that you neglect yourself and develop bad habits. And most of all, find a primary care doctor that you feel comfortable with and keep up with your regular checkups.
