Abdominal Swelling: Possible Liver Issues Explained

Abdominal issues?

Hello doctor, two months ago I noticed swelling in the area of my right upper abdomen near the rib cage.
The condition has not improved since then, but there is no pain or obvious symptoms in the swollen area.
During these two months, I have lost about five kilograms, although my weight has recently increased slightly.
My appetite has not been affected, and I had a complete blood count (CBC) test done, which showed no issues.
Since I have a habit of staying up late, I would like to ask if this could be related to liver problems.
Thank you.

K, 10~19 year old female. Ask Date: 2021/08/06

Dr. Chen Shidian reply Gastroenterology and Hepatology

Ultrasound examination.

Reply Date: 2021/08/06

More Info

Hello! Thank you for reaching out with your concerns regarding the abdominal swelling you’ve been experiencing. Given your description of the swelling in the right upper abdomen near the rib cage, along with the weight loss and the absence of pain or other significant symptoms, it’s important to consider a few potential underlying issues, particularly related to liver health, especially since you have a history of hepatitis B.

Firstly, the liver is located in the right upper quadrant of the abdomen, and any swelling or enlargement in this area could potentially indicate liver-related issues. Conditions such as fatty liver disease, hepatitis, or even liver cirrhosis can lead to an enlarged liver (hepatomegaly), which might present as swelling. In your case, the fact that you have hepatitis B makes it crucial to monitor your liver health closely, as chronic hepatitis B can lead to progressive liver damage over time.

The weight loss you mentioned, although slight, can be a concern. Unintentional weight loss can sometimes indicate underlying health issues, including liver disease. However, since you noted that your appetite remains unaffected, this could suggest that the weight loss is not directly related to a lack of caloric intake but may be due to other factors, such as metabolic changes or fluid shifts in the body.

Your normal Complete Blood Count (CBC) results are reassuring, as they suggest that there are no immediate signs of infection or significant blood-related issues. However, liver function tests (LFTs) would provide more specific information regarding your liver health. These tests measure enzymes and substances in your blood that can indicate how well your liver is functioning. Elevated liver enzymes could suggest inflammation or damage to liver cells, which is particularly relevant for someone with a history of hepatitis B.

Additionally, the habit of staying up late can contribute to various health issues, including stress on the liver. Chronic sleep deprivation can lead to metabolic disturbances and may exacerbate existing liver conditions. It’s essential to maintain a healthy lifestyle, including adequate sleep, a balanced diet, and regular check-ups with your healthcare provider.

Given your symptoms and history, I strongly recommend that you consult with a hepatologist or a gastroenterologist. They may suggest further imaging studies, such as an ultrasound or CT scan, to evaluate the liver's size and structure and to rule out any other potential causes of the swelling, such as cysts or tumors. Additionally, they may recommend liver function tests and possibly a viral load test to assess the status of your hepatitis B infection.

In summary, while the swelling in your abdomen may not currently be accompanied by pain or other alarming symptoms, it is crucial to take it seriously, especially given your background with hepatitis B. Regular monitoring and proactive management of your liver health are essential to prevent potential complications down the line. Please ensure you follow up with your healthcare provider for a comprehensive evaluation and tailored advice based on your specific situation. Thank you for your inquiry, and I wish you the best in your health journey!

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