Liver Health: Addressing Abdominal Discomfort and Concerns

Regarding issues related to the "liver" and "abdominal discomfort."

Hello, Dr.
Hsu.
I would like to ask you a few questions and provide some context first.
For the past four to five days, I have been experiencing some discomfort in the upper abdomen, particularly in the right upper quadrant.
The discomfort feels like mild cramping pain that occurs intermittently (every few hours), lasting for a few seconds before disappearing.
Since I work at a front desk and frequently have to get up and turn around to attend to other tasks, I often feel fatigued.
Coupled with this discomfort, I sometimes wonder if it’s psychological, as I occasionally experience soreness in my lower back, arms, and shoulders, which comes and goes.
However, I notice significant improvement when I return home.
I do feel a bit strange in the right upper abdomen when lying on my stomach.
This situation has occurred once or twice in the past few years, typically lasting about a week before resolving (and this time seems no different).

Could you please explain how this might relate to the liver? I have recently come across a lot of information regarding liver cancer, bile duct cancer, pancreatic cancer, stomach cancer, and kidney cancer, which has made me extremely anxious about possibly having a serious illness.
I undergo health check-ups approximately every one to two years, and all my indicators are normal, except for slightly elevated liver function tests due to moderate fatty liver.
Does this increase my risk of developing liver cancer? I have antibodies for hepatitis B but do not have the virus itself.

I usually go to bed around 1 AM and wake up around 8 AM.
Given my physiological background, does sleeping at this time harm the liver? Does it increase the risk of liver cancer? Is it necessary for the liver to detoxify between 11 PM and 2 AM? What happens if this window is missed? Could it be serious? Is my situation severe? Recently, I have tried palpating my abdomen and found no abnormalities, and I do not exhibit any signs of jaundice.
My appetite is also normal.
However, I have heard that those with liver cancer often feel fatigued.
A couple of days ago, I visited a museum in Taipei and felt suddenly very tired after being there for an hour or two, almost as if I had a fever.
I felt better after staying in a bookstore with air conditioning for a while.
Is this a symptom of liver cancer?
I sincerely apologize if my questions seem off-topic, and I hope you can help clarify my concerns.
Thank you very much.

Xiao Dong, 20~29 year old female. Ask Date: 2007/05/28

Dr. Xu Jinchuan reply Gastroenterology and Hepatology

Hello! The symptoms mentioned in the letter are not related to the liver.
Since you do not have hepatitis B, it is likely that you do not have hepatitis C either (I'm not sure if you have been tested?).
The probability of developing liver cancer is very low; however, if you are still concerned, I recommend that you schedule an examination with a hepatologist or a family medicine physician.
Speculating without proper evaluation is not the correct approach.
From a medical standpoint, there is no such thing as a detoxification period, but maintaining a regular lifestyle is indeed a way to promote health, isn't it? Many diseases can present with symptoms such as abdominal pain or fatigue, but it is difficult to make an online diagnosis based solely on symptoms.

Reply Date: 2007/05/28

More Info

Hello! Thank you for reaching out with your concerns regarding your liver health and the discomfort you’ve been experiencing in your upper abdomen. It’s understandable to feel anxious, especially when you’ve been reading about serious conditions like liver cancer, pancreatic cancer, and others. Let’s break down your concerns and provide some clarity.

Firstly, the discomfort you’re feeling in your upper abdomen, particularly on the right side, could be related to several factors. Given your history of mild fatty liver and elevated liver function tests, it’s important to consider that fatty liver disease can sometimes lead to discomfort or pain in the liver area. However, the symptoms you describe—intermittent dull pain that improves when you rest—could also be related to muscle strain, especially since you mentioned your job involves a lot of physical movement. Stress and anxiety can also manifest physically, leading to muscle tension and discomfort.

Regarding your concern about liver cancer, it’s important to note that while having fatty liver can increase the risk of liver-related complications, including liver cancer, the presence of B hepatitis antibodies indicates that you are not currently infected with the virus, which is a positive sign. Regular check-ups and monitoring of liver function are crucial. If your liver function tests have been stable and you are not experiencing any alarming symptoms (such as jaundice, significant weight loss, or persistent fatigue), it is less likely that you are facing a severe liver condition.

You also asked about your sleep patterns and their impact on liver health. While it is true that the liver has a natural detoxification process that is more active during the night, particularly between 1 AM and 3 AM, missing this window occasionally is not likely to cause significant harm. However, consistent late nights and poor sleep can contribute to overall health issues, including liver health, especially if it leads to increased stress or poor dietary choices.

The fatigue you experienced after visiting the museum could be attributed to various factors, including physical exertion, dehydration, or even a mild viral infection. It is not specifically indicative of liver cancer. Symptoms of liver cancer often include significant weight loss, loss of appetite, persistent fatigue, and jaundice, among others. If you are not experiencing these symptoms, it is less likely that your fatigue is related to a serious liver condition.

In summary, while your concerns are valid, it’s essential to approach them with a balanced perspective. Continue to monitor your liver health through regular check-ups, maintain a healthy lifestyle, and manage stress effectively. If your symptoms persist or worsen, or if you develop new symptoms, it would be prudent to consult with a healthcare professional for further evaluation. Remember, being proactive about your health is key, and staying informed can help alleviate some of your worries. If you have any further questions or need clarification, feel free to ask!

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