AFAB, 41, obese but losing (down over 30 lbs since June), 5’5” Complicated medical history (can answer any questions) Many medications

Due to a combination of factors [including NAFLD, genetic hypertriglyceridemia (has been measured well over 700, was over 600 in childhood) and mitochondrial disease], my liver has been enlarged for quite a while and over the past few years has enlarged further. The last CT scan of my abdomen in the spring of this year measured my liver at “over 25 cm” and the surgeon who removed my gallbladder a year ago just described it as “massively enlarged”.

My LFTs are completely normal and other than one issue in response to a medication have always been normal. Recently I developed an incredible pressure and pain in my stomach (mid upper abdomen) unlike anything I have experienced before that fails to respond to basically every stomach medication (anti nausea meds, Reglan, Carafate, Bentyl, Dexilant along with Famotidine, Maalox, Maalox with lidocaine (GI cocktail), etc). It feels sort of like the worst Charlie horse you have ever experienced but in your stomach/upper abdomen combined with intermittent sharp pain and just tremendous pressure. It is often worse after eating but is persistent even after 24 hours of not eating. A scope is scheduled in about two weeks, but no recent imaging has been done. Could my liver be enlarged enough to be putting pressure on my stomach or otherwise be contributing to the pain even with normal labs?

*If it matters my spleen is also enlarged although not to the same degree as my liver.