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What Causes Fatigue And Pain Below Rib Cage?
Question: sir, my sgpt is 190,sgot 84,total bilirubin 0.8,protein 8.2,albumin 5.2,haemoglobin 14.6,platellets 1.6 lakhs . my usg showed gall bladder stone 1.7 cm,hepatomegaly,fatty liver with grade two changes,liver 17 cm. my fibroscan showed f2 fibrosis(7.9 kpa) and 66% steteoisis.(s3)
presently i am on the drugs heptral 400 mg(twice) evion 400 ursocol sr(450 mg)(twice) and nexpro
i feel fatigue and occasional pain below/near right rib cage.
kindly suggest
presently i am on the drugs heptral 400 mg(twice) evion 400 ursocol sr(450 mg)(twice) and nexpro
i feel fatigue and occasional pain below/near right rib cage.
kindly suggest
Brief Answer:
weight loss and evion
Detailed Answer:
Hello XXXXXXX
I would need a few clarifications
1 do you consume alcohol
2 were tests for hepatitis B and C , ANA and ceruloplasmin done.
3 was an eye examination slit lamp examination done
4. Have you been taking pin killers or other medications for a long time
5. What is you weight and height
In case you drink alcohol I would suggest to stop it completely.
I would suggest to get the tests mentioned ( if not done till date)
I f all tests are negative and you do not drink alcohol then your diagnosis is XXXXXXX ( nonalcoholic steatohepatitis) which is due to fat deposition in the liver
I would suggest to continue vitamin E
Continue exercise and diet with the aim of weight loss ( in case you are over weight)
Hope this helps
Do get back
Regards
DrSamir Patil
weight loss and evion
Detailed Answer:
Hello XXXXXXX
I would need a few clarifications
1 do you consume alcohol
2 were tests for hepatitis B and C , ANA and ceruloplasmin done.
3 was an eye examination slit lamp examination done
4. Have you been taking pin killers or other medications for a long time
5. What is you weight and height
In case you drink alcohol I would suggest to stop it completely.
I would suggest to get the tests mentioned ( if not done till date)
I f all tests are negative and you do not drink alcohol then your diagnosis is XXXXXXX ( nonalcoholic steatohepatitis) which is due to fat deposition in the liver
I would suggest to continue vitamin E
Continue exercise and diet with the aim of weight loss ( in case you are over weight)
Hope this helps
Do get back
Regards
DrSamir Patil
Above answer was peer-reviewed by :
Dr. Yogesh D
ceruloplasmin 18.9 ana is negative. i am non-alcoholic completely.hepatitis b and c negative. weight 85kg height 175 cm. no medication for long time.
can i continue with heptral 400,ursocol and nexpro along with evion?
can i take livopil along with the above medicines?
what is my next step?
what about gall stone?
can i continue with heptral 400,ursocol and nexpro along with evion?
can i take livopil along with the above medicines?
what is my next step?
what about gall stone?
Brief Answer:
livopill not needed. no treatment for gall stone
Detailed Answer:
Hello,
I seems that your complete workup has been done,
I would make a diagnosis of XXXXXXX based on this yo need to continue evion on along term basis. You can take heptral along with it. UDCa does not have a major role.
There is no evidence that livopill will help in XXXXXXX
You can continue nexpro
about your gall stone
In case you do not have pain there is no need to do any thing about.
You will need surgery for your gall stone only if
1 you have pain caused by the gall stone
2 there is thickening/contraction of the gall bladder on ultrasound
3 youbdevelop jaundice because of gallstones
4 if you have pancreatitis.
As you do mpt have any of the above I would leave the stone alone and not worry about it now.
Hope this helps
Do get back I'm case you have further queries
Regards
Dr Samir Patil
livopill not needed. no treatment for gall stone
Detailed Answer:
Hello,
I seems that your complete workup has been done,
I would make a diagnosis of XXXXXXX based on this yo need to continue evion on along term basis. You can take heptral along with it. UDCa does not have a major role.
There is no evidence that livopill will help in XXXXXXX
You can continue nexpro
about your gall stone
In case you do not have pain there is no need to do any thing about.
You will need surgery for your gall stone only if
1 you have pain caused by the gall stone
2 there is thickening/contraction of the gall bladder on ultrasound
3 youbdevelop jaundice because of gallstones
4 if you have pancreatitis.
As you do mpt have any of the above I would leave the stone alone and not worry about it now.
Hope this helps
Do get back I'm case you have further queries
Regards
Dr Samir Patil
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
sir i have occasional pain near right rib cage.is it due to gall stone or liver fibrosis?
do i need any further tests now like biopsy?
can i take milk thistle along with the medicines?
sir what type of diet shall i follow?
can i continue with normal office job and exercise?
kindly suggest.
is there any possibility of cirrosis or malignancy?
do i need any further tests now like biopsy?
can i take milk thistle along with the medicines?
sir what type of diet shall i follow?
can i continue with normal office job and exercise?
kindly suggest.
is there any possibility of cirrosis or malignancy?
Brief Answer:
Can continue routine activities
Detailed Answer:
Hello,
Liver fibrosis does not cause pain.
Mild pain is in likely to be due to gallstone. A physical examination should help to determine the cause. If the pain is persists a repeat ultrasound will help. A HIDA scan might be helpful (I wouldn’t advise you to go for it right now if the pain is mild) in case the pain worsens.
You can take milk thistle.
I would advise you to avoid
Fried foods
Fast foods
Avoid sweets and confectioneries.
Increase fruit and green veggies in your diet.
Regular exercise
Minimum 20- 40 min 4 times a week
In case the SGOT and SGPT remain persistently high after 3 to six months I would advise a liver biopsy.
You can continue with your job.
The chances of cirrhosis and malignancy are low
Regards
Dr Samir Patil
Can continue routine activities
Detailed Answer:
Hello,
Liver fibrosis does not cause pain.
Mild pain is in likely to be due to gallstone. A physical examination should help to determine the cause. If the pain is persists a repeat ultrasound will help. A HIDA scan might be helpful (I wouldn’t advise you to go for it right now if the pain is mild) in case the pain worsens.
You can take milk thistle.
I would advise you to avoid
Fried foods
Fast foods
Avoid sweets and confectioneries.
Increase fruit and green veggies in your diet.
Regular exercise
Minimum 20- 40 min 4 times a week
In case the SGOT and SGPT remain persistently high after 3 to six months I would advise a liver biopsy.
You can continue with your job.
The chances of cirrhosis and malignancy are low
Regards
Dr Samir Patil
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
can i take amway nutrilite for liver containing milk thistle,turmuric and dandalion ?
do u suggest any other source for milk thistle?
can i take this along with the medicines(heptral,evion,nexpro,ursoco)?
kindly suggest
do u suggest any other source for milk thistle?
can i take this along with the medicines(heptral,evion,nexpro,ursoco)?
kindly suggest
Brief Answer:
silymarin tab
Detailed Answer:
The best source of milk thistle will be tab silymarin(will have a higher content than nutralite ).Which contains extract of milk thistle. You can safely take it with your other meds.
Hope this helps
Regards
Dr Samir Patil
silymarin tab
Detailed Answer:
The best source of milk thistle will be tab silymarin(will have a higher content than nutralite ).Which contains extract of milk thistle. You can safely take it with your other meds.
Hope this helps
Regards
Dr Samir Patil
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
sir can f2 fibrosis(7.9 kpa on fibroscan) be reversed. if yes how? if no then how long it will take to reach f4 stage?
Brief Answer:
reversible
Detailed Answer:
Hello, fibroscan is not very accurate to determine F2 fibrosis it is very accurate for f4 . So your liver could still be normal. If it indeed is F2 fibrosis the it can be reversible. Treatment is regular exercise , weight loss ( if overweight), avoid alcohol.
Progression can take decades 10 to 30 years and is seen in only a small proportion.
Hope this helps
Regards
Dr Samir Patil
reversible
Detailed Answer:
Hello, fibroscan is not very accurate to determine F2 fibrosis it is very accurate for f4 . So your liver could still be normal. If it indeed is F2 fibrosis the it can be reversible. Treatment is regular exercise , weight loss ( if overweight), avoid alcohol.
Progression can take decades 10 to 30 years and is seen in only a small proportion.
Hope this helps
Regards
Dr Samir Patil
Above answer was peer-reviewed by :
Dr. Raju A.T
sir u said progression can take 10 years....progression means what? from f2 to f4 or f2 to f1? i am on regular exercise(swimming,pranayam,yoga,walking for 2 hours daily)...and on homely diet only with restricted sugar,salt and only olive oil. plenty of green vegetables and fruits....medicines taken are heptral 400 mg twice daily,evion 400 twice,livopill ds twice,and nexpro once daily...is this ok? or any suggestions?
Brief Answer:
meds are OK.
Detailed Answer:
Hello,
I meant f 2 to f4
You can continue all the above medications
Livopill can be discontinued. Healthy diet and exercise are the most effective measures
Regards
Dr Samir Patil
meds are OK.
Detailed Answer:
Hello,
I meant f 2 to f4
You can continue all the above medications
Livopill can be discontinued. Healthy diet and exercise are the most effective measures
Regards
Dr Samir Patil
Above answer was peer-reviewed by :
Dr. Prasad
Brief Answer:
no additional medications needed
Detailed Answer:
Hello,
You do not need additional medications.
I would advise you to monitor sgot and sgpt every 3 months.
You can continue the vitamin tabled. Ursocol is not harmful but expected benefit is low hence ,can be stopped.
There is some evidence that f2 fibrosis can be reversed. But we do not have enough evidence to give a time frame.
Hope this helps
Regards
Dr Samir Patil
no additional medications needed
Detailed Answer:
Hello,
You do not need additional medications.
I would advise you to monitor sgot and sgpt every 3 months.
You can continue the vitamin tabled. Ursocol is not harmful but expected benefit is low hence ,can be stopped.
There is some evidence that f2 fibrosis can be reversed. But we do not have enough evidence to give a time frame.
Hope this helps
Regards
Dr Samir Patil
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Brief Answer:
not a reason for concern
Detailed Answer:
Hello livopill is safe and can be taken for a month. Weight loss is beneficial in fatty liver. If it is due to exercise and diet then 1 kg per week is acceptable so 4 kg in a month is not a cause for worry.
Regards
Dr Samir Patil
not a reason for concern
Detailed Answer:
Hello livopill is safe and can be taken for a month. Weight loss is beneficial in fatty liver. If it is due to exercise and diet then 1 kg per week is acceptable so 4 kg in a month is not a cause for worry.
Regards
Dr Samir Patil
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Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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