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From your query I understood your concern. Epigastric pain radiating to back and shoulders should be evaluated for gastric discomforts like gastritis and cholecystitis which is very common in deranged lipid profile. I believe this is due to hyperlipidemia.
Your lipid profile is out of proportion. You need to bring these values down. Also you need investigations and thorough assessment to rule out other hereditary causes of hyperlipidemia.
Below mentioned measures have to be followed to maintain the cholesterol within range,
- You need workup for pancreas, gallbladder and amylase levels.
- Get an abdominal ultrasound to rule out any gallstones.
- It can be controlled by taking lipid lowering agents like statin analogues or resins to reduce cholesterol absorption.
- Follow the diet and lifestyle modifications mentioned below.
- Once ruled out, likely possibility would be gastritis which is easily manageable with some antacids and some proton pump inhibitors.
A good and most important start would be to lose weight at least 33 lbs. Your current BMI (body mass index) is 27 which means your are obese, reduce it to less than 25. The key is healthy diet and lifestyle, regular exercise, weight balance, etc.
Choose healthier fat like omega 3, omega 6, mono and polyunsaturated fat (olive oil, canola oil, almonds, walnuts, etc) and say good bye to bad cholesterol like saturated fat. Planning diet with limited fat intake will also help. Make sure that you get no more than 300 mg of cholesterol a day.
Select grains with more fiber such as wheat, pasta, corn flour, etc. Prefer fresh fruits and vegetables. Avoid processed and canned products as well as fries. Eat heart friendly fish with less fat content like tuna, mackerel, salmon, halibut etc.
Avoid alcohol, if impossible keep the intake to minimum and never exceed moderation levels. Avoid smoking. Doing exercise regularly for 45 minutes a day and 250 minutes a week should be your main goal. Artichoke, garlic, oat bran, sitostanol (stigmastanol), blond psyllium, margarines, etc., can help. Lipid lowering agents like statin analogues can be considered too. Talk to your doctor for physical examination and let them help you in this regard.
Investigations to be done:
1. Abdominal ultrasound.Treatment plan:
2. Serum amylase, lipase, amylase to lipase ratio.
3. Urinary amylase.
4. GI endoscopy.
5. 24 hour pH monitoring.
6. Work up for hereditary causes of hyperlipidemia.
1. Diet and lifestyle modifications.Preventive measures:
2. Statin analogues.
3. Symptomatic care.
Diet and lifestyle modifications.