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Suggest Treatment For Hepatitis-E Jaundice
Question: I am suffering from Hep-E Jaundice, S Bil Total 4.8 SGOT 1076, SGPT 888 I am diabetic, I was advised Urudohep sl 300 . I started the medicine on 15/11/2014 after two days I stopped Urdohep as feeling very uneasy. Fasting sugar on 15/11/2014 was 296, Today 103. Fever was coming up to 102 for 15 to 17 then it stopped but again revived on 20/11/2014.
What should be next course of action
What should be next course of action
Brief Answer:
Treatment is mainly supportive
Detailed Answer:
Hi XXXXXXX,
Welcome to HCM. I had gone through your question, reports and understand your concerns.
Don't worry.
Hepatitis E jaundice is usually a self-limiting disease. Only supportive treatment is needed in majority of cases. The liver enzymes are grossly elevated. Urdohep SL will help to increase bile excretion and decrease jaundice. But if you cannot tolerate it you can stop it. Increase the fluid intake and take food at the correct time.
Please keep in touch with your doctor and have your liver enzymes monitored weekly till it is normal.
For Diabetes:
The elevated sugars initially is due to hepatitis. The medication you are on for diabetes (Gminor M-2 forte) is not recommended in hepatitis. So consult your doctor for change in medications. The drugs safe in hepatitis are insulin, gliptins and small dose of glyclazide. Your doctor will be able to help you with the prescription.
Hope I have answered your question. If you have any further questions I will be happy to help.
Regards
Dr Ajish TP
Consultant Endocrinologist
Treatment is mainly supportive
Detailed Answer:
Hi XXXXXXX,
Welcome to HCM. I had gone through your question, reports and understand your concerns.
Don't worry.
Hepatitis E jaundice is usually a self-limiting disease. Only supportive treatment is needed in majority of cases. The liver enzymes are grossly elevated. Urdohep SL will help to increase bile excretion and decrease jaundice. But if you cannot tolerate it you can stop it. Increase the fluid intake and take food at the correct time.
Please keep in touch with your doctor and have your liver enzymes monitored weekly till it is normal.
For Diabetes:
The elevated sugars initially is due to hepatitis. The medication you are on for diabetes (Gminor M-2 forte) is not recommended in hepatitis. So consult your doctor for change in medications. The drugs safe in hepatitis are insulin, gliptins and small dose of glyclazide. Your doctor will be able to help you with the prescription.
Hope I have answered your question. If you have any further questions I will be happy to help.
Regards
Dr Ajish TP
Consultant Endocrinologist
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Body temperature is 100.4 deg F presently, can paracetamol safe be taken ? Before diagnosis of Juandice she had taken at least 6 paracetamol 650 during 11th Nov to 14th Nov and after 15th Nov it was stopped.
Also there was itching and allergy problem (12-14 Nov) for which she had taken evil and other injections. She was also having nausea problem and her weight reduced by 3 kg during 11 to 14 Nov.
What should be taken in food ? Because Diabetes and Jaundice both factors will have to be considered
Also there was itching and allergy problem (12-14 Nov) for which she had taken evil and other injections. She was also having nausea problem and her weight reduced by 3 kg during 11 to 14 Nov.
What should be taken in food ? Because Diabetes and Jaundice both factors will have to be considered
Brief Answer:
You can take paracetamol after consulting a physician
Detailed Answer:
Hi,
I have understood your concern in using antipyretics in liver disease.
All medications used for fever can cause problems in liver disease. But this is more in advanced liver disease. Among the drugs paracetamol is more safe compared to other drugs like aspirin or ibuprofen. Maximum dose per day is 3000 mg per day. So you can safely take 3-4 tablets per day. Any how consult your doctor to assess the liver status.
Hope I have answered your question. If you have any further questions I will be happy to help.
Regards
Dr Ajish TP
Consultant Endocrinologist
You can take paracetamol after consulting a physician
Detailed Answer:
Hi,
I have understood your concern in using antipyretics in liver disease.
All medications used for fever can cause problems in liver disease. But this is more in advanced liver disease. Among the drugs paracetamol is more safe compared to other drugs like aspirin or ibuprofen. Maximum dose per day is 3000 mg per day. So you can safely take 3-4 tablets per day. Any how consult your doctor to assess the liver status.
Hope I have answered your question. If you have any further questions I will be happy to help.
Regards
Dr Ajish TP
Consultant Endocrinologist
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
What about weight loss and itching/allergy which had relapsed yesterday but automatically reduced today.
Kindly also advice about proper food to be taken
Kindly also advice about proper food to be taken
Brief Answer:
These are common symptoms with hepatitis
Detailed Answer:
Hi,
Itching is usually seen in Hepatitis. This is due to bile stasis (decreased excretion of bile from liver). Avil will help in relieving itching. Nausea and weight loss are associated features. No special diet is needed in hepatitis. A balanced diet with adequate calories and protein is needed. Have plenty of oral fluids
Regards
Dr Ajish TP
Consultant Endocrinologist
These are common symptoms with hepatitis
Detailed Answer:
Hi,
Itching is usually seen in Hepatitis. This is due to bile stasis (decreased excretion of bile from liver). Avil will help in relieving itching. Nausea and weight loss are associated features. No special diet is needed in hepatitis. A balanced diet with adequate calories and protein is needed. Have plenty of oral fluids
Regards
Dr Ajish TP
Consultant Endocrinologist
Above answer was peer-reviewed by :
Dr. Raju A.T
As per today’s report, Fasting Blood Sugar is 87 which has reduced from 296 on 15th November.
S. Bilirubin has increased from 4.8 to 13.0.
Report was shown to Doctor and he suggested that diabetic medication is alright and also the earlier medication for diabetes prior to 15th November, Gemer Forte 2 is stronger than Gminor M2 Forte.
He also advised Urdo Hep SL should not have been discontinued because it’s protecting the liver and it should be re started, which I have already re started yesterday and there is tolerance in the patient to this medicine.
He finally advised for insulin as suggested by you and the advise is also attached.
You’re requested to kindly suggest for further course of action as the jaundice is increasing & sugar is decreasing. Report and Advise attached as two new files
S. Bilirubin has increased from 4.8 to 13.0.
Report was shown to Doctor and he suggested that diabetic medication is alright and also the earlier medication for diabetes prior to 15th November, Gemer Forte 2 is stronger than Gminor M2 Forte.
He also advised Urdo Hep SL should not have been discontinued because it’s protecting the liver and it should be re started, which I have already re started yesterday and there is tolerance in the patient to this medicine.
He finally advised for insulin as suggested by you and the advise is also attached.
You’re requested to kindly suggest for further course of action as the jaundice is increasing & sugar is decreasing. Report and Advise attached as two new files
Brief Answer:
Continue insulin and medications for hepatitis
Detailed Answer:
Hi XXXXXXX,
I have gone through the reports.
The next course of action if I were your treating physician will be
1. For Diabetes
Continue with Novomix insulin .
Decrease or stop the oral medications till liver functions are normalized. (Which is the current recommendation)
Maintain the fasting plasma glucose less than 130 mg/dl and after food < 180 mg/dl
2. For hepatitis
Supportive treatment with oral or intravenous fluids.
UrdoHep SL have some role in decreasing bilirubin.
Wait and assess thing every day and decide based on that. Bilirubin will initially worsen followed by improvement.
Discuss all about this with your doctor.
Follow up with physician regularly.
So don't worry.
Hope I have answered your question. If you have any further questions I will be happy to help.
Regards
Dr Ajish TP
Consultant Endocrinologist
Continue insulin and medications for hepatitis
Detailed Answer:
Hi XXXXXXX,
I have gone through the reports.
The next course of action if I were your treating physician will be
1. For Diabetes
Continue with Novomix insulin .
Decrease or stop the oral medications till liver functions are normalized. (Which is the current recommendation)
Maintain the fasting plasma glucose less than 130 mg/dl and after food < 180 mg/dl
2. For hepatitis
Supportive treatment with oral or intravenous fluids.
UrdoHep SL have some role in decreasing bilirubin.
Wait and assess thing every day and decide based on that. Bilirubin will initially worsen followed by improvement.
Discuss all about this with your doctor.
Follow up with physician regularly.
So don't worry.
Hope I have answered your question. If you have any further questions I will be happy to help.
Regards
Dr Ajish TP
Consultant Endocrinologist
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
As per today’s report, FBS is 87 which has reduced from 296 on 15th November.
S. Bilirubin has increased from 4.8 to 13.0.
Report was shown to Doctor and he suggested that diabetic medication is alright and also the earlier medication for diabetes prior to 15th November, Gemer Forte 2 is stronger than Gminor M2 Forte.
He also advised Urdo Hep SL should not have been discontinued because it’s protecting the liver.
He finally advised for insulin and the advise is also attached.
You’re requested to kindly suggest for further course of action as the jaundice is increasing & sugar is decreasing.
S. Bilirubin has increased from 4.8 to 13.0.
Report was shown to Doctor and he suggested that diabetic medication is alright and also the earlier medication for diabetes prior to 15th November, Gemer Forte 2 is stronger than Gminor M2 Forte.
He also advised Urdo Hep SL should not have been discontinued because it’s protecting the liver.
He finally advised for insulin and the advise is also attached.
You’re requested to kindly suggest for further course of action as the jaundice is increasing & sugar is decreasing.
Brief Answer:
Please see the previous answer
Detailed Answer:
Hi XXXXXXX,
Hope your queries were answered in the previous question. The viral hepatitis is having a variable course which we cannot predict. There is specific anti viral agent needed in this stage of disease. So we have to wait for the natural course of disease, see for complication and give supportive treatment. Once started on insulin the sugars can be brought in control by adjusting the dose of insulin. We have to come down on insulin dose if sugars are decreasing.
Wishing you speedy recovery
Regards
Dr Ajish TP
Consultant Endocrinologist
Please see the previous answer
Detailed Answer:
Hi XXXXXXX,
Hope your queries were answered in the previous question. The viral hepatitis is having a variable course which we cannot predict. There is specific anti viral agent needed in this stage of disease. So we have to wait for the natural course of disease, see for complication and give supportive treatment. Once started on insulin the sugars can be brought in control by adjusting the dose of insulin. We have to come down on insulin dose if sugars are decreasing.
Wishing you speedy recovery
Regards
Dr Ajish TP
Consultant Endocrinologist
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
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