I am very concerned about my liver. I have a history of alcohol use of approximately two to four beers per night, approximately five nights per week for nearly 20 years. I am under total abstinence for the past one year.
My symptoms are aching pain in the back on the right side under the rib cage (worse the longer I stand up), total loss of libido with erectile dysfunction.
Recent blood labs showed AST 17, ALT 20, ALP 69, GGT 15, albumin 4.62, but elevated bilirubin at 0.52 direct and 0.64 indirect (total bilirubin -1.16), and low platelets at 127. Prior blood labs from one and a half years ago showed elevated bilirubin at 1.7 (total) and platelets at 158. However, platelets were also at 127, just one week before when they were measured at 158. Despite total bilirubin being lower than before, I can now notice slight jaundice on the skin of my face and on my fingers, but no one else seems to notice this.
Is there concern for cirrhosis given the low platelets, elevated bilirubin, and erectile dysfunction? Are the APRI score (0.34) and fib-4 score (1.17) useful in ruling out fibrosis in my case? Or might the AST be misleading in this case? What should someone do in my case? Is it possible that there is liver inflammation from too much alcohol for many years? Is a fibroscan recommended?