ZocdocAnswersThe result of my MRI is that I have a fatty liver without focal lesion, what should I do next?

Question

The result of my MRI is that I have a fatty liver without focal lesion, what should I do next?

Hello, last week I had an MRI. The results are back with "Fatty infiltration of the liver without evidence for a focal lesion within it or hepatosplenomegaly. My question is that every evening in between 5-8pm I am experiencing a burning pain in the liver area. The blood tests have all returned normal with no elevation. Yet I still continue to experience this pain every evening. I will add that I am also vomiting bile and have had pain in my kidney areas that fluctuates from a stabbing sensation to a burning depending on what I eat. My main question is a liver biosy a viable way to check to see if something else is going on or would it first be better to do another imaging test of the liver, with contrast and ask my doctor about that instead. This last one did not use contrast. Thanks

Answer

I would suggest that you schedule an appointment with a gastroenterologist. Fatty liver is one of the most common problems we have in the United States. Fatty liver is caused by many different problems including being overweight, poor diet, diabetes, and metabolic syndrome. People with a fatty liver are more prone to liver disease and can have slight elevation of their liver function tests. However, a fatty liver does not tend to cause or rarely ever cause abdominal pain. Therefore I think that your abdominal pain that you are having every day is probably not related to the liver at all. It sounds more like it is related to a gallbladder problem, a pancreas problem, or perhaps a stomach problem. For this, I would probably first get an abdominal ultrasound to check for gallbladder stones. If these were present then you might want to consider consultation with a surgeon to have the gallbladder removed. I might also consider a CT scan with contrast to look for problems with the pancreas but this is not the first thing that you should have done. Another option would be consultation with a gastroenterologist for an upper endoscopy which can take a look at the stomach and rule out things like stomach ulcers. Certainly liver biopsy at this point would help confirm your diagnosis of fatty liver but would not change any management at this time. For this problem, I would suggest that you schedule an appointment with a gastroenterologist who can direct all of this further testing and future care.

This answer is for general informational purposes only and is not a substitute for professional medical advice.

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