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Nearly 100% (probably exactly 100%) of morbidly obese people have a fatty liver, which IS a hepatitis (Non-alcoholic Steatohepatitis or NASH) and can present with the same symptoms as any other hepatitis, including the viral hepatitises. It can also result in cirrhosis, which simply means scarring of the liver, and liver failure if it progresses. WLS surgery and the resultant weight loss can cause the loss of fat in the liver and can reverse some of the damage IF you do not consume alcohol, smoke or eat high fat foods.

After gastric bypass, the liver is working extra hard to process the fat out of the liver resulting in high enzyme levels. It is important that NO alcohol be consumed if you have any form of hepatitis, including NASH. Do not smoke or allow yourself to be exposed to smoking. Avoid any environmental toxins.

Many physicians do not take this condition as seriously as they should. Make sure your doctor DOES. This means a biopsy of the liver during surgery or after if it wasn't done in the surgery (a liver biopsy is recommended by the Society of Bariatric surgery, so it should have been done during surgery, especially if your surgeon saw any abnormality, including those nodes)

Check out the website below my name for articles on NASH. Also, check out the blog on healthy strategies for your liver. Too much meat protein is not so good. Try to vary your diet and rely on at least some plant proteins. They are easier on the liver. Also 90 grams of protein is an awful lot and could be too much. You cannot absorb more than 20-30 grams normally and the rest leaves your body via your kidneys. This puts a strain on the kidneys.

Have your vitamin K levels checked and your B vitamins. These are vitamins that can affect your enzyme readings and may require supplementation. B vitamins can affect memory, especially B-12 and B-6. Ask your doctor about supplementing with B-50s in addition to your current regimine.

Your questions:

"1. If I find I have Hep C, what are the chances of a 49 year-old african-american woman getting a transplant if it is needed? I fear that I'm not in the group that great attempts would be made to acquire one."

The chances of you needing a transplant are very remote if you take care of yourself and follow the rules of the gastric bypass.

As an African American, statistically, you are less likely to be referred to a transplant center by your doctor BUT once you get that referrral your chances of getting a transplant are as good as anyone on the list. As a group, African Americans do not donate their organs in large numbers. You might want to take that on in terms of awareness in your community. It increases the chances for all on the transplant list equally. However, origin (in terms of race) of the organ makes no difference in the successful outcome of the transplant.

"2. Is it safe to assume that having hep of any kind, would exclude me from having plastic surgery to remove the excess skin from this weight loss?"

No, it does not exclude you. You can have the plastic surgery if you meet all other criteria.

"3. My memory is the pits! If this is a result of the Hep, will I ever regain it?"

This may have to do with your nutritional status post surgery, especially B vitamins.

"4. How does Hep affect my ability to work with other people in the long term? One of my dreams was to go to Israel and/or Africa to work there in a missionary status (I'm a bible college student). Would this prevent me from working in other countries? Will I not be able to work in certain places?"

You will always need to pay attention to your nutritional needs and this may limit where you can safely live and work. The US military will not accept someone who has had WLS for this reason.

"5. The "nodes" or fibrosis as you call it. What and how does the doctor determine the stages? And can you have them and it not be Hep?"

Without a liver biopsy, we can only make a wild guess. Not a good idea. But, nodes can be fat or tissue or scar tissue. No way to tell without a biopsy.

"6. How could a surgeon see this and not tell you to get this checked out? I don't get this at all."

This is a question you need to ask the surgeon. I am as puzzled as you are.

For more, check out the website under my name or refer to past posts on this site in the archives.

I hope this helps,


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