Q. Please interpret my ultrasound finding for grade 2 fatty liver.

Answered by
Dr. Arbab Muhammad Kashif Khan
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Aug 16, 2020

Hello doctor,

I have frequent urination, excessive sweating, mouth dryness, stomach bloating and flatulence (gas formation), tiredness, feels sleepy all the times, stomach heaviness all the time, excessive farting especially in the evening, headache in the morning once I getup.

Ultrasound finding fatty liver grade 2 shows:

ALP- 119.

GGTP- 121.

ALT- 120.

AST- 58.

Triglyceride- 146.

Cholesterol total- 198.

Uric acid- 2.60.

Creatinine- 0.64.

Urea- 17.70.

Fasting sugar - 152.

HbA1c - 8.7.

Chloride- 98.10.

Potassium- 3.47.

Sodium- 136.70.

Phosphorus- 4.0.

Calcium -8.96.

ESR- 47.

TSH- 6.48.

T3- 1.33.

T4- 7.50.

MPV - 12.70.

Protein %- 10mg/dl.

Ketones- negative.

Bilirubin - negative.

MCHC- 31.70.

RDW- 14.60.

Bilirubin total- 0.56.

Bilirubin direct- 0.11.

Bilirubin indirect- 0.45.

HDL- 42.10.

eAG- 203.

I am currently on Livokot tablets for liver two tablets BD, Vitamin E 400 once daily, and Vitamin D3 sachet once weekly.

#

Hello,

Welcome to icliniq.com.

Do you have any prior history of diabetes? If yes, since how long and what medication do you use for diabetes? Do you have any history of diarrhea, constipation or weight loss or abdominal pain? Do you feel heat intolerance, increased anger, etc? Since how long are you feeling gas formation? What medication have you tried? Did you ever had raised ALT before? Any other medication you use?


Investigations to be done:

HBsAg, Anti HCV by ELISA.

Thank you doctor,

I do not have a prior history of diabetes and not taking any medicine until now. As far as I remember, no history of diarrhea but some times I feel constipated and then I took Triphala for the same. I do feel excessive anger suddenly.

For the last two weeks, I am feeling excessive gas being generated by my body. In order to relieve from the same I take Digene syrup. And yes, for the last few years my AST is raised. I consulted a physician before and he gave some medicines and do not remember the name but it is a common medicine for the liver that also saves from gallbladder stones.

#

Hi,

Welcome back to icliniq.com.

You have raised HbA1c (Glycated hemoglobin) and you need to start treatment for it. Meanwhile, you have to decrease your weight which will control your diabetes, help your gas problem and help normalizing ALT (alanine transaminase) and AST (aspartate aminotransferase).

I will write some medicine for your diabetes (life long) as well as gas problems. Please note that avoid lactulose if you ever use any medication for constipation because it increases gas and flatulence. Please continue with Vitamin E and Ursodiol (if you are taking it). Your TSH (thyroid-stimulating hormone) is raised, but you do not need to be bothered as T3 and T4 are normal.


The Probable causes:

Diabetes mellitus. Fatty liver. Dyspepsia.

Treatment plan:

Tablet Metformin 500 mg thrice daily with meals (may increase the dose slowly after a week according to the tolerance), Levosulpiride 25 mg thrice a day before meals for a month, Mebeverine 135 mg thrice a day for a month.

Preventive measures:

Daily exercise and decrease weight. Decrease carbohydrates and sugar in the diet.


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