Dr. Anshul Varshney
Internal Medicine
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Patient's Query
Hello doctor,
I am a hypertensive and diabetic patient with FBS 100 to 110, PPBS 120 to 130, HbA1c 5.3 (last measured), taking Glyciphage 1 gm, Telmisartan 40, and Amlodipine 5 mg. Clinical BP 150/100, just after clinic 125/78, at home 115/75. Fatty liver II, prostrate 25 CC (no problem urinating, no burning sensation, etc.,), lipids are under control.
I would like to know how to reduce the fatty liver condition from II to I. Is any medicine available? I had suffered from hepatitis two times during childhood at 7 and 10 years of age. No smoking and drinking at all. No pain in the abdomen. The problem faced now are that for the past few days, I am suffering from excessive gas, bloating, and discomfort in the neck and food pipe, as if some air is trapped which is expelled as burps at times and relieved after I took Pudin Hara (Ayurvedic medicine) and Raciper plus (given to my wife when she was suffering from IBS). No difficulty swallowing food. But a light pain in the neck which is relieved with flushing out the air. Please advise for medication. I had experienced this condition in the past also say 2 to 3 years back and that time it was good using Omez for few days. I am having microalbuminuria sometimes. It is below (UACR values).
Hi,
Welcome to icliniq.com.
For the treatment of fatty liver, first of all, I need to know your liver function test. If you have your recent liver function test (LFT) reports please attach it. If not done yet, please get it done and write back to me.
Patient's Query
Thank you doctor,
I am attaching all reports LFT, lipids, UACR trends, HbA1c, FBS, PPBS. Please revert back with medicine for fatty liver. Currently, facing gastritis problem and variation of UACR.
Hi,
Welcome back to icliniq.com.
After evaluating your reports (attachment removed to protect patient identity), I would recommend you weight reduction for fatty liver. A few people advise tablet Udiliv (Ursodeoxycholic acid) but do not recommend it much in cases like yours. Weight reduction, exercise is the key to treatment.
For urinary protein, I would recommend you to take low protein diet. Strict control of blood sugar and blood pressure is required. Discuss with your doctor to add up tablet Ramipril in low dose for control of proteinuria.
Patient's Query
Thank you doctor,
If you do not mind mentioning the reason for not prescribing Udiliv even for a short duration. I request you to comment on medications for stomach related problems mentioned earlier.
Hi,
Welcome back to icliniq.com.
Actually, Udiliv is usually given to people with very high SGOT and SGPT which is not your case. Suppose you take it for a few weeks and do not adopt lifestyle changes, then, still your fatty liver would persist. So, weight reduction and right diet is the key.
For your acidity related problems, take a combination of Pantoprazole and Domperidone once daily for a few weeks. Again weight reduction and right diet play a very good role in treatment for acid reflux.
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Internal Medicine
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