For a couple of months I had been experiencing pain on my right side, under my ribs, wrapping around to my back. I had an ultrasound done at 34 weeks to investigate, as my symptoms sounded like gall bladder disease / gall stones. Everything looked normal except for a “1.0 cm right subscapular echogenic area, likely representing a liver hemangioma.” Well, that is where my pain is, however, the report noted that “No cause for patient’s pain is identified.”
From what I’ve read on the internet, other people have experienced pain there, mimicking gall stones, only to be told it’s a liver hemangioma, and that it shouldn’t be causing pain. Several people also noted that they have IBS (irritable bowel syndrome), which I have been told I have due to years of constipation and bloating (basically since birth).
Recently, in January 2010, I started getting other weird symptoms like numbness and tingling. After 6 months of seeing 8 different doctors, including the emergency room at the hospital, an endocrinologist (I have Graves disease), a neurologist (for the numbness & tingling), and a rheumatologist (who told me it was fribromyalgia, which it isn’t), I was finally diagnosed with vitamin B12 deficiency (it was 115 at the time), low calcium (hypocalcemia), and low ferritin (anemia). The current hypothesis is malabsorption and I go to see a gastroenterologist in February, and I’m getting an MRI just to rule out anything else (Jan 2012 – completed – came back clean.)
So, after 3 months of supplements with vitamins I find I still have malabsorption issues (diarrhea), despite many pills a day:
- 2 mg+ Calcium
- 4 IU vitamin D
- 1-2 Iron pills a day (Palifer/Euro Fer)
- Vitamin C (I take with iron, and now with each meal as I read it can help with malabsorption)
- B12 (sublinguals and injections)
- prenatal vitamin
- B complex vitamin
- 1 magnesium pill
I suspect that my history with IBS could be caused by low stomach acid (hypochlorhydria ). It is interesting that the low vitamins happened less than 2 years after my Graves disease diagnosis, which makes me wonder if any of it is autoimmune. Pernicious anemia (low b12) can be caused by an autoimmune disorder, but doesn’t explain the low calcium. Updated Jan 2012 – I feel fairly certain it’s adrenal fatigiue/insufficiency
So, until I have this baby (less than 4 weeks to go!), and until I see a gastroenterologist (3.5 months from now), I just have to keep taking vitamins, ignore the pain under my right ribs, and hope that it’s all treatable in January!
I know a scope of my stomach and colon is likely in my future, but if it produces the cause of my symptoms (hopefully, all benign), then I’ll be happy. However, I am disappointed that it is taking so long to diagnose. It’s already been 9 months since the onset of my symptoms and it will be over a year before I see the gastroenterologist (it took 3 months of supplements not making much of a difference, and even then, I had to ASK to see one).
Note: my Graves Disease has been perfect throughout pregnancy. I take a pill at breakfast (50 mg), and another pill at bedtime (50 mg). I will let you know if it flares up after birth, but so far, so good!
Post-Birth update
About a week after birth my calcium levels seem to be off. I feel very hypocalcemic, however, I’m taking more calcium than ever (up to 4,000 mg / day). My lips are tingling and my muscles get crampy. However, I’m prone to constipation right now – well, large, firm stools right now, which is odd because I’ve had fibrous, slimy bowel movements leading up to birth, despite the calcium and iron I’m taking.
Update: Jan 2013
Still have constant flank pain in this region. Kidneys look okay. Think this might be the source of all my problems – liver cyst.
Abdominal pain
Nauseated feeling
Eruption of the cysts
Digestive problems
Shoulder pain
Liver enlargement
Blockage of bile ducts
Infection of the bile ducts
Diagnosis and Treatment
Diagnosis of liver cysts is done when a patient undergoes a CT (Computed Tomography) scan or an ultrasound procedure of the abdomen. Usually, they are detected incidentally, while doing imaging tests for other abdominal problems. If required, examination of a sample of fluid from the cysts, biopsy of the affected tissues and blood test (for parasitic infection cases) is conducted. It is common that an individual has more than one cyst in the liver tissues and rarely, there are multiple cysts.
Since liver cysts don’t disturb the normal functioning of the body, there are no significant treatment methods. In case, the cysts are big enough (for example more than 3 cm), it is advisable to go for a follow-up abdominal imaging to check the growth of cysts. People go for treatment of liver cysts only after they experience discomfort symptoms that disturb their normal routine. Treatment for the same is done by aspiration and/or surgical removal of the cysts.
Of the two available treatment methods, removal of the cysts via laparoscopic surgery is a more reliable intervention. Simple aspiration of the cysts is not recommended, as fluid tends to fill up the cysts after some time. In the surgery, 2-3 small excisions are made in the abdomen. With the help of laparoscope, a large part of the affected tissues including the cyst wall is removed, and the incisions sites are sutured. Laparoscopic surgery is also recommended, if the cysts prevent normal flow of bile juice to the small intestine.
This minimally invasive procedure requires 1-2 days hospital stay. Usually, candidates achieve full recovery within 2 weeks after the surgery. As the liver regenerates on its own, it recuperates successfully. In case, the cysts are infected, then treatment may include administration of antibiotics and other prescribed medications along with excision of the tissues and cysts. For people who have participated surgery for hepatic cyst treatment, recurrence rate is very low (almost negligible).
To conclude with, no specific treatment is needed for asymptomatic liver cysts. However, one should be aware about the complications of liver cysts, such as infection, jaundice (yellowing of the skin and sclera), bleeding into cyst (causing pain) and disturbance of the flow of bile juice. If anybody suspects that he/she has liver cysts, it is recommended to consult and seek advice from a physician so as to get proper medical attention. Except for the mild discomfort cases, hepatic cysts do not pose risks for liver cancer and liver failure.
Read more at Buzzle: http://www.buzzle.com/articles/liver-cysts.html
Graves Disease Diary 