My father has liver issues and gallstones. How to manage?

Question

Hi doctor,

My father does not talk much about his health, and I do not know much about it since I do not see him a lot. He is taking a lot of medications, but I have no idea what that was for. He will not tell me even if I ask him. All I know is that he is sick and that he is taking medications.

He is working abroad, and they have greasy food at work. Last year, he told me that he was having liver issues. He gets severe swelling under his feet, and he feels like he is walking on glass. I feel like he has stomach issues because of his gallstones.

I hope that there is still a non-invasive treatment for his health issues, which is why I seek your help.

I have attached his ultrasound results.

Liver:

Mildly enlarged in size, measuring about 159 mm with a bright texture.
No evidence of focal lesions or dilated intrahepatic biliary radicles.
The main portal vein is not dilated, measuring about 9 mm. (Normally up to 13 mm)

Gall bladder:

Gallbladder stone measuring about 11 mm, without posterior shadowing.
Normal size with regular wall thickness.
No detectable stone. It is not specifically tender on probing.
The common bile duct is not dilated.

Conclusion:

Mild fatty hepatomegaly.
Calcular gallbladder.

What is the best treatment solution? We would greatly appreciate your response.

Answer 1

Hi,

Welcome to icliniq.com

I am very sorry about your medical condition, and I am glad that you are paying attention to changes in your father’s body system. But do not worry, I am here to take care.

Thank you for sharing the ultrasound report. Here is a breakdown of the findings and possible treatment approaches:

Mild fatty hepatomegaly means that the liver is slightly enlarged and has fatty infiltration ("fatty liver"). Common causes for this condition include:

Obesity.
Poor diet.
Diabetes.
High cholesterol.
Alcohol use.
Certain medications.

Stage "Mild" suggests early-stage fatty liver disease (likely non-alcoholic fatty liver disease, NAFLD).
A gallbladder stone (a calculus) of approximately 11 mm means the gallstone is without "posterior shadowing," which sometimes happens with cholesterol stones or small soft stones.
No signs of inflammation, thickening, or tenderness means there is no acute cholecystitis, no current infection or blockage.
The common bile duct and portal vein are normal, which means there is no bile flow obstruction.

Recommended treatment approach for your father:

For mild fatty liver (Fatty hepatomegaly):

Weight loss: Aim to lose five to ten percent of body weight (gradually) through diet and exercise.
Healthy diet: Low in sugar, refined carbs, and saturated fats. Focus on vegetables, whole grains, lean protein, healthy fats (like omega-3s).
Exercise: At least 30 minutes a day, five days a week (like brisk walking, swimming).
Control underlying conditions: Diabetes, high cholesterol, or hypertension should be medically managed.
Avoid alcohol: Even small amounts can worsen fatty liver.
Monitor liver function tests (LFTs) and repeat ultrasound in six to 12 months.

For a gallstone (approximately 11 mm, non-tender, non-obstructive). Asymptomatic gallstones typically do not require surgery unless there are symptoms like:

Right upper abdominal pain (especially after fatty meals).
Nausea or vomiting.
Fever or jaundice (yellowing of eyes or skin).

In such cases, Laparoscopic cholecystectomy (gallbladder removal) is standard. Otherwise, only watchful waiting is advised, and surgery is not needed. Avoid fatty foods to reduce the risk of gallstone attacks.

Medications like Ursodeoxycholic acid are sometimes used to dissolve cholesterol stones, but this is slow, often not effective for large stones, and rarely the first choice.

I hope this answers your query.

Feel free to reach out in case of further queries.

Thank you.