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What Causes Fatty Liver?
Question: Dear Dr.
Kindly let me have advice /reply from a Gastroenterologist. Even though Your Dr XXXXXXX XXXXXXX replied to me for my earlier queries on the subject and his advise helped me for diagnosing my case further, I need a 2nd opinion from a Gastroenterologist.
I had diagnosed with elevated SGPT 96 in October 2013 but Total Bilirubin was normal with 0.4 mg/dl and I was under treatment of Udiliv 300 mg twice a day for two months and SGPT come down to 51 in December 2013 and doctor stopped treatment. But after 3 months in April 2014 sgpt again raised to 106 , in May 2014 it is 96 units after taking Livomyn syrup for one month and restarted taking Udiliv 300 in the last week of May 2014.
Report of USG whole abdomen taken on 2.6.2004 - Liver -enlarged in size (measures 15.6 cm AP). Homogenous echotexture. No IHBRD/focal SOL is seen. Hepatic vessels are normal. PV-normal. Porta hepatis normal.
Gall bladder - Few hyperechoic foci are seen, largest measuring 18.1 mm in lumen. Wall thickness is normal. CBD normal.
Pancreas, Spleen, Both kidneys, urinary bladder, prostate are normal
Impression: Cholelithiasis, Hepatomegaly
Blood test HBsAg : Normal, Anti HCV : Non reactive
Dr. prescribed be Heptral 400 mg (Ademetionine)twice a day in addition to Udiliv 300 mg twice a day. and advised me to take both the medicines and report back after 1 month.
I want your 2nd opinion on the matter. Is it necessary to take Heptral 400 mg along with Udiliv 300 mg which is a very costly medicine? ?? I want to know, can both the drugs be taken together without any side effects?. Yesterday I started taking the medicine Heptral along with Udiliv. My mouth was dry in the night and some areas in my chest appeared reddish today in the morning with slight itching temptation. . Now 90% reddish disappeared. Is it allergic reaction? What is the real cause of my liver enlargement ?? Is it liver cirrhosis ? Is any further test required to diagnosis the real cause ? Is the stone in my gall bladder causing problems. These stones are silent and I have no pain now. I used to take one or two peg alcohol, low quantity, once or twice in a month in parties etc. I am taking food only in low quantites and not taking fried items. I have problem of indigestion and feeling fullness of stomach if I take extra quantity of food items. So I am taking less quantity of food at a time.
It may please note that without taking Udiliv 300 mg or Heptral 400 mg SGPT come down from 106 to 96 by using aurvedic syrup Livomyn of charak co. for one month. What this indicate ????
I am also taking Enalapril Maleate (Envas) 5 mg for BP. Earlier I had taken Neurobin forte tablet/b complex tablet for 2 months as I have burning sensation in my soles of both feet, but of no use.CBC was done in November 2013. Results are within the limit except platelet count was 92,000 below normal range.. Lipid profile done in October 2013, cholesterol level was within limit, Sugar is also within limit, however Random sugar test done in this May 2014 was 61.6 mg/dl below normal value.
Awaiting your early reply/advise/2nd opinion.
Kindly let me have advice /reply from a Gastroenterologist. Even though Your Dr XXXXXXX XXXXXXX replied to me for my earlier queries on the subject and his advise helped me for diagnosing my case further, I need a 2nd opinion from a Gastroenterologist.
I had diagnosed with elevated SGPT 96 in October 2013 but Total Bilirubin was normal with 0.4 mg/dl and I was under treatment of Udiliv 300 mg twice a day for two months and SGPT come down to 51 in December 2013 and doctor stopped treatment. But after 3 months in April 2014 sgpt again raised to 106 , in May 2014 it is 96 units after taking Livomyn syrup for one month and restarted taking Udiliv 300 in the last week of May 2014.
Report of USG whole abdomen taken on 2.6.2004 - Liver -enlarged in size (measures 15.6 cm AP). Homogenous echotexture. No IHBRD/focal SOL is seen. Hepatic vessels are normal. PV-normal. Porta hepatis normal.
Gall bladder - Few hyperechoic foci are seen, largest measuring 18.1 mm in lumen. Wall thickness is normal. CBD normal.
Pancreas, Spleen, Both kidneys, urinary bladder, prostate are normal
Impression: Cholelithiasis, Hepatomegaly
Blood test HBsAg : Normal, Anti HCV : Non reactive
Dr. prescribed be Heptral 400 mg (Ademetionine)twice a day in addition to Udiliv 300 mg twice a day. and advised me to take both the medicines and report back after 1 month.
I want your 2nd opinion on the matter. Is it necessary to take Heptral 400 mg along with Udiliv 300 mg which is a very costly medicine? ?? I want to know, can both the drugs be taken together without any side effects?. Yesterday I started taking the medicine Heptral along with Udiliv. My mouth was dry in the night and some areas in my chest appeared reddish today in the morning with slight itching temptation. . Now 90% reddish disappeared. Is it allergic reaction? What is the real cause of my liver enlargement ?? Is it liver cirrhosis ? Is any further test required to diagnosis the real cause ? Is the stone in my gall bladder causing problems. These stones are silent and I have no pain now. I used to take one or two peg alcohol, low quantity, once or twice in a month in parties etc. I am taking food only in low quantites and not taking fried items. I have problem of indigestion and feeling fullness of stomach if I take extra quantity of food items. So I am taking less quantity of food at a time.
It may please note that without taking Udiliv 300 mg or Heptral 400 mg SGPT come down from 106 to 96 by using aurvedic syrup Livomyn of charak co. for one month. What this indicate ????
I am also taking Enalapril Maleate (Envas) 5 mg for BP. Earlier I had taken Neurobin forte tablet/b complex tablet for 2 months as I have burning sensation in my soles of both feet, but of no use.CBC was done in November 2013. Results are within the limit except platelet count was 92,000 below normal range.. Lipid profile done in October 2013, cholesterol level was within limit, Sugar is also within limit, however Random sugar test done in this May 2014 was 61.6 mg/dl below normal value.
Awaiting your early reply/advise/2nd opinion.
Brief Answer:
Answer given below
Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.
One of the mots common causes of raised SGPT is fatty liver.
Your ultrasound scan shows hepatomegaly which could be due to fatty liver.There are many different causes of fatty liver and alcohol intake is one of the causes. Other causes include obesity, diabetes, high cholesterol.
You have not mentioned about SGOT. So I cannot comment whether your fatty liver is an alcoholic fatty liver or a non-alcoholic fatty liver.
If it is alcoholic fatty liver quitting alcohol will reverse it in about 3 months time. Heptral will hasten the recovery.
No you are not having cirrhosis.
I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.R.K
Answer given below
Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.
One of the mots common causes of raised SGPT is fatty liver.
Your ultrasound scan shows hepatomegaly which could be due to fatty liver.There are many different causes of fatty liver and alcohol intake is one of the causes. Other causes include obesity, diabetes, high cholesterol.
You have not mentioned about SGOT. So I cannot comment whether your fatty liver is an alcoholic fatty liver or a non-alcoholic fatty liver.
If it is alcoholic fatty liver quitting alcohol will reverse it in about 3 months time. Heptral will hasten the recovery.
No you are not having cirrhosis.
I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.R.K
Above answer was peer-reviewed by :
Dr. Raju A.T
Thanks for the kind advice & prompt reply, SGOT 70, SGPT 96 in May 2014. SGOT 46, SGPT 62 in November 2013. I am non-diabetic with normal level cholesterol, I am not overweight, only taking one or two alcoholic drinks in a month. Kindly advice me further
I also want to know if bacteria in the intestine cause liver disease. I feel full stomach even after taking low quantity of food, so taking small meals three times a day instead of 2 big meals, Gas problem is also there. Kindly advice for tests/blood tests to find out any bacteria in my intestine
regards
XXXXXX
I also want to know if bacteria in the intestine cause liver disease. I feel full stomach even after taking low quantity of food, so taking small meals three times a day instead of 2 big meals, Gas problem is also there. Kindly advice for tests/blood tests to find out any bacteria in my intestine
regards
XXXXXX
Brief Answer:
breath test, culture of the small intestinal aspirate
Detailed Answer:
Hi,
Thanks for providing the additional information.
Your SGPT is more than SGOT which indicates it is more of a non alcoholic fatty liver.
Trimeg would be a better option than heptral. And if obese you need to reduce weight.
Yes there is a theory that intestinal bacteria can lead to fatty liver. Some of the tests done to diagnose it are breath test, culture of the small intestinal aspirate.
I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.R.K
breath test, culture of the small intestinal aspirate
Detailed Answer:
Hi,
Thanks for providing the additional information.
Your SGPT is more than SGOT which indicates it is more of a non alcoholic fatty liver.
Trimeg would be a better option than heptral. And if obese you need to reduce weight.
Yes there is a theory that intestinal bacteria can lead to fatty liver. Some of the tests done to diagnose it are breath test, culture of the small intestinal aspirate.
I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.R.K
Above answer was peer-reviewed by :
Dr. Raju A.T
Dear Dr.
Thanks for your immediate reply. I would like to request you to have your final recommendation /opinion for the following:
1. Whether I continue to take Udiliv 300 twice for another 2 to 3 months so that SGPT can come done ?? I am considering to stop taking Heptral as per your advice. I have some tablets left out, about 10 tablets of 400 mg. Can I take Heptral 400 mg once in a day instead of Heptral 400 mg twice in a day as recommended by Dr. Is it needed ??
2. When will the next US of whole abdomen to be done to assess the condition of enlarged liver ? after 1 or 2 months ??
3. Is it necessary to done operation for the removal of gall bladder/gall bladder stone in the immediate future as it is a silent stone ?? I have no pain in the upper region of the stomach.
4. Udiliv 300 tablet is also used for dissolution of gall bladder stone. Whether I continue to take udiliv 300 for longer period so that gall stone can get dissolved.
5. Can you prescribe a medicine to be taken for feeling of full stomach after taking small quantity of food and also medicine for gas producing in my stomach.
6. Whether I have to go for further investigation for feeling of full stomach. If so advice.
Kindly let me have your reply so that I can proceed further in this matter.
I shall be thankful to you,
With regards,
XXXXXXX
Thanks for your immediate reply. I would like to request you to have your final recommendation /opinion for the following:
1. Whether I continue to take Udiliv 300 twice for another 2 to 3 months so that SGPT can come done ?? I am considering to stop taking Heptral as per your advice. I have some tablets left out, about 10 tablets of 400 mg. Can I take Heptral 400 mg once in a day instead of Heptral 400 mg twice in a day as recommended by Dr. Is it needed ??
2. When will the next US of whole abdomen to be done to assess the condition of enlarged liver ? after 1 or 2 months ??
3. Is it necessary to done operation for the removal of gall bladder/gall bladder stone in the immediate future as it is a silent stone ?? I have no pain in the upper region of the stomach.
4. Udiliv 300 tablet is also used for dissolution of gall bladder stone. Whether I continue to take udiliv 300 for longer period so that gall stone can get dissolved.
5. Can you prescribe a medicine to be taken for feeling of full stomach after taking small quantity of food and also medicine for gas producing in my stomach.
6. Whether I have to go for further investigation for feeling of full stomach. If so advice.
Kindly let me have your reply so that I can proceed further in this matter.
I shall be thankful to you,
With regards,
XXXXXXX
Brief Answer:
Answer given below
Detailed Answer:
Hi,
1. yes you can continue udiliv 300 for 3 months.
2. You can get the USG done after 3 months.
3. Since the gallstones has remained silent till now, there is no need for surgery now.
4. You have a 1.8 cm gallstone. Udiliv cannot dissolve it.
5. You can take Nexprol-L once a day before breakfast for 4 weeks.
6. Yes, you have to check blood glucose and H.pylori infection if not done already.
Regards,
Dr.R.K.
Answer given below
Detailed Answer:
Hi,
1. yes you can continue udiliv 300 for 3 months.
2. You can get the USG done after 3 months.
3. Since the gallstones has remained silent till now, there is no need for surgery now.
4. You have a 1.8 cm gallstone. Udiliv cannot dissolve it.
5. You can take Nexprol-L once a day before breakfast for 4 weeks.
6. Yes, you have to check blood glucose and H.pylori infection if not done already.
Regards,
Dr.R.K.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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