What Causes Itching On The Feet And Pain That Radiates To The Back And Shoulder?

Posted on Tue, 4 Apr 2017

Question: 35 year old white male. History of binge drinking. Frequent URQ pain, radiating to back and right shoulder blade. Red palms and itching feet. Clear abdominal ultrasound 10 months ago for liver, but 3mm sludge ball present in GB. Is cirrhosis possible?
I have quit drinking, what should my next step be?
I have attached ultrasound report and pic of hands.

Answered by Dr. Shafi Ullah Khan (1 hour later)

Brief Answer:
No cirrhosis, needs followup and supportive care

Detailed Answer:
Thank you for asking

I read your question and i understand your concern, Your abdominal ultrasound is clear and does not indicate any cirrhosis in it. However biliary sludge of 3 mm may be the cause of this pain in the quadrant. Now that you have stopped binge drinking, supportive and symptomatic care will improve symptoms. Use of antacids like proton pump inhibitors, frequent hydrations, minimum use of dairy products and fatty spicy foods , alcohol, beverages etc will improve the symptoms. Cirrhosis is not a concern here, but follow ups should be maintained every 3 months for the sludge as it can cause pancreatitis and cholecystitis . SOme work up on amylase and lipases profile to rule out any pancreatitis is advised.

Red palms and itchy feet is likely a separate entity or a withdrawal effect of alcohol as that can cause thiamine deficiency and can cause such sensory neuropathies. Let your doctor have a look at it and prescribe you some multivitamins and supportive care and work you up meanwhile for any metabolic disorder.

I hope it helps. Take good care of yourself and dont forget to close the discussion please.

Regards
Khan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shafi Ullah Khan (10 minutes later)

Thank you doctor, do I need a liver biopsy? I've read that ultrasounds cannot definitively diagnose cirrhosis. my doctor thinks I may have Gilberts. Could that cause my symptoms?

Answered by Dr. Shafi Ullah Khan (6 minutes later)

Brief Answer:
Supportive care

Detailed Answer:
Thank you for getting back to me

With nothing on ultrasound , you don't' need any liver biopsy and even XXXXXXX is remote possibility . You just need diet and lifestyle modifications and abstinence from alcohol and 3 monthly follow up for this 3mm biliary sludge . Even if they label it with XXXXXXX XXXXXXX cause no harm and can maximum cause slight jaundice on stress or infection any where in the body nothing else. Stop worrying, no need to do any further battery of tests, Just observe and modify lifestyle and diet.

I hope it helps.
Regards
Khan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shafi Ullah Khan (7 minutes later)

Sounds like a plan. No matter how much I've drank over the past 10 months, I couldn't have gone from clear ultrasound to cirrhosis in that short of time could I? Regardless of symptoms? My itching and red hands concern me, but maybe that is gallbladder.

Answered by Dr. Shafi Ullah Khan (23 minutes later)

Brief Answer:
No worries, supportive care

Detailed Answer:
Thank you for getting back to me

As i mentioned its not cirrhosis. Drinking might have caused vitamin deficiencies that can cause this itching in hands. Raised bilirubin levels can cause itching as well but that is not limited to just hands and feet and involve whole body so less likely. Take some B complex multivitamins and benadryl for this itch and consult your local physician and let them have a look at this itch and correlate it for possible cause.

I hope it helps.
Regards
Khan

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar