Symptoms: Liver Pain, Lymph Nodes, and Sleep Issues

Q: Symptoms: Liver Pain, Lymph Nodes, and Sleep Issues

Hello： 1. <br>The more common causes of liver inflammation are hepatitis B, hepatitis C, fatty liver disease, and alcoholic hepatitis. <br>Liver function tests require blood draws for diagnosis. <br>Regarding the intermittent sharp pain in your left and right abdomen, it is advis

Lymph nodes, liver, neck, rib pain, and bruising during sleep?

1.
About five years ago, I had liver inflammation issues when I was around 20 years old.
I felt a bloated, numb sensation, as if there was something hard inside.
At that time, the doctor diagnosed me with fatty liver.
I had not started smoking yet, but I was taking oral contraceptives.
After a while, the discomfort eased, and I didn't feel much.
When I was 17, I once ate squid jerky that my family brought back from abroad, and I ended up with very green stools.
Could that have damaged my liver? A few years later, I started feeling uncomfortable again; by then, I had been smoking for about a year, around the age of 22, and I had stopped taking contraceptives.
I later bought liver support supplements from the pharmacy, which helped a bit.
Recently, I noticed sharp pain near my left rib cage.
I saw a doctor who suggested it might be rib inflammation, but it was just a consultation.
Could this be related to a pancreatic issue? I experience intermittent sharp pain on both sides, which eases when I press on it.
The discomfort in my liver area also alleviates with pressure.
Are these issues related to my ribs? Sometimes, I do find myself slouching while sitting.
2.
Recently, I noticed that I can't lift my neck high, and I feel tightness in the skin around my throat and chin.
I'm not sure if it's a tongue or skin issue.
Why is this happening? Which specialty should I consult, or should I just engage in self-exercise?
3.
I previously had swollen lymph nodes, and the doctor mentioned it was due to an immune system disorder.
This lymph node issue has persisted for several years, with occasional inflammation and swelling.
I first noticed it when I was around 17-18 years old, with swelling behind my ears and around my neck.
The doctor only prescribed antibiotics, and it never completely resolved, so I stopped seeing the doctor.
4.
I recently changed my bed to a firmer one, and I got used to sleeping on my left side.
Last week, I noticed pain in my abdomen above the pelvis, and a few days later, I started developing small bruises.
For the past few days, I've felt pain on the left side of my lower abdomen, and I still have a bruised sensation, although I don't see any visible bruises.
Could this simply be due to the bed being too hard, or is there an underlying health issue? The situation is quite complex, and every time I visit the doctor, they seem busy and rushed, so I hesitate to ask too many questions.
I would appreciate it if you could advise me on what I should pay attention to, which specialty to consult, and what steps I should take.
Thank you, doctor.

Lin, 20~29 year old female. Ask Date: 2023/01/16

Dr. Lin Zhebin reply Family Medicine

Hello: 1.
The more common causes of liver inflammation are hepatitis B, hepatitis C, fatty liver disease, and alcoholic hepatitis.
Liver function tests require blood draws for diagnosis.
Regarding the intermittent sharp pain in your left and right abdomen, it is advisable to consult a family medicine physician or a gastroenterologist.
2.
For your neck discomfort, it may be necessary to consider whether it is related to cervical spine issues or thyroid problems.
A visit to a family medicine physician or a neurologist is recommended.
3.
If the swelling of your lymph nodes persists without resolution, it is advisable to see a family medicine physician or a hematologist/oncologist.
4.
For the bruising in your abdomen and left-sided pain, consulting a family medicine physician or a gastroenterologist is recommended.
In summary, your health conditions are relatively numerous and complex, so it is suggested to first visit a family medicine physician, who can refer you to other specialists as needed.
Additionally, since the consultation time is limited, it would be best to address your most uncomfortable symptoms first, and manage the other symptoms during follow-up visits.

Reply Date: 2023/01/16

More Info

Understanding the symptoms related to liver health, lymph nodes, and sleep issues can be complex, especially for individuals with a history of liver problems such as hepatitis or fatty liver disease. Based on your description, several interconnected issues may be at play, and it’s essential to approach them systematically.

Liver Health and Symptoms
1. Previous Liver Issues: You mentioned having liver inflammation and being diagnosed with fatty liver disease at a young age. Fatty liver can lead to inflammation and potentially progress to more severe liver conditions if not managed properly. The symptoms you described, such as a feeling of heaviness or discomfort in the liver area, can be associated with liver issues. However, it’s important to note that liver pain is not always localized; it can sometimes manifest as discomfort in the upper abdomen or even radiate to the back.

2. Bowel Movements and Liver Health: The episode of passing green stools after consuming squid could indicate a gastrointestinal issue rather than direct liver damage. Green stools can result from rapid transit through the intestines or dietary factors. However, if you have ongoing concerns about your liver health, it would be prudent to have regular check-ups that include liver function tests (like ALT and AST) and possibly imaging studies.

3. Recent Symptoms: The left rib pain you are experiencing could be related to rib inflammation, as suggested by your doctor. However, it’s also crucial to consider other potential causes, including issues with the spleen or even referred pain from the liver. If the pain persists or worsens, further evaluation, such as an ultrasound, may be warranted to rule out any underlying conditions.

Lymph Nodes and Immune Response
1. Lymph Node Swelling: Your history of swollen lymph nodes and immune system issues could be linked to chronic inflammation or infection. Lymph nodes can swell in response to various factors, including infections, autoimmune diseases, or malignancies. If you notice recurrent swelling, it’s advisable to consult a healthcare provider for further evaluation, possibly including blood tests or imaging studies to assess the lymphatic system.

Sleep Issues and Physical Discomfort
1. Sleep Quality: The discomfort you experience when sleeping on a hard mattress could be contributing to your overall discomfort and potentially affecting your sleep quality. Poor sleep can exacerbate feelings of fatigue and discomfort, leading to a cycle of poor health. If you suspect that your mattress is too hard, consider adjusting your sleeping arrangements to find a more comfortable position.

2. Neck and Throat Tension: The tightness in your neck and throat could be related to muscle tension, possibly exacerbated by poor posture or stress. Engaging in gentle stretching exercises or consulting a physical therapist may help alleviate this tension. If the symptoms persist, it might be worth consulting an ENT specialist to rule out any underlying issues.

Recommendations
- Consult a Specialist: Given the complexity of your symptoms, it may be beneficial to see a gastroenterologist for your liver concerns and a rheumatologist or an immunologist for your lymph node issues. A physical therapist could also assist with your musculoskeletal discomfort.

- Regular Monitoring: Keep up with regular liver function tests and imaging studies as recommended by your healthcare provider. Monitoring your liver health is crucial, especially given your history.

- Lifestyle Adjustments: Consider dietary changes to support liver health, such as reducing alcohol intake, avoiding processed foods, and incorporating more fruits and vegetables. Regular exercise can also help improve overall health and potentially alleviate some of your symptoms.

- Sleep Hygiene: Focus on improving your sleep environment. If your mattress is too hard, consider using a softer mattress topper or changing your sleeping position to enhance comfort.

In conclusion, while some of your symptoms may be interconnected, it’s essential to approach each one with careful consideration and seek appropriate medical advice. Regular follow-ups and open communication with your healthcare providers will be key in managing your health effectively.

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