Brief Answer:
Fatty liver is not abnormal finding.Do not worry.

Detailed Answer:
Hi,

I have gone through your query and understand the concern.

From the facts you have shared here,you are likely having fatty liver (grade-III) which is a harmless condition as such and is reversible if you treat the risk factors.

Some of the causes of fatty liver are alcohol intake, obesity, diabetes, high cholesterol and certain medications.

Also, I would like to say that fatty liver is not an alarming finding. It indicates fatty tissue deposition on the liver like in all men who have fatty or pendulous abdomen. Therefore I wouldn't be personally worried about this finding.

Here, I would like to ask some questions,

Let me know your height and weight,
Can you brief me about your daily eating habits?
Do you drink alcohol (if yes, then how much),
Do you have any clinical symptoms?
Have you visited some local doctor for the same?
Any other blood or liver function tests done?

Generally,fatty liver condition is a kind of obesity. And grade-iii fatty liver is also reversible up to certain extent by dietary measures and regular exercises.

Hope this information will help you and kindly get back to me with these answers.I will give my opinion after that.

Regards,

Dr.Sandip Kabra

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Brief Answer:
Fatty liver is reversible.

Detailed Answer:
Hi,
Thanks for sharing more information.

Your height and weight which has increased by 5 kg in last one year, is NOT the big issue.

But as we discussed,Grade-iii fatty liver is reversible up to some extent in the initial stages specially, by following below mentioned corrective measures.

1) Do regular exercise or brisk walk at least 30 minutes per day.
2) Complete cessation of alcohol intake and smoking.
3) Avoid junk foods and fast foods,if possible make a regular eating habits.
4) Also take low fat and high protein diet (Veg- Pulses, soyabean and cheese)
5) Take more fresh fruits and vegetables.

Although there is no such a time limit on when to have a repeat ultrasound scan but it can be repeated after 3 months following above corrective measures to check the liver status.

For cough with or without phelgm,chest pain and generalized bodyache is likely related to upper respiratory tract infection (like pharyngitis) or may be acute bronchitis but it should be evaluated further by clinical examination and various tests.

So,in my advise you should go for some routine blood works (CBC),ESR and X- ray chest (if NOT done earlier) which will be helpful to make some clear diagnosis whether it is due to viral infection or bacterial (like streptococcal pharyngitis) or some allergic.

However,generally this kind of cough with chest pain are viral origin and very unlikely to be due to bacterial infection.

You will require,

1) Pain killer and anti-inflammatory combinations like paracetamol 500mg with ibuprofen 400 mg to reduce body pain,headache and further inflammation in throat.

2) Take tablet Mucinex-Dm (available OTC) twice daily which contains Dextromethorphan which is a cough suppressant in combination with Guaifenesin which is an expectorant and helps to loosen congestion in your throat and making it easier to cough out mucus/phlegm.

3) Nebulizer (with budesonide respules) 3 to 4 times a day with steam inhalation will also be helpful to prevent further episodes of coughing and steam inhalation will loosen the cough making easier to expel out the mucus through mouth.

4) Drink plenty of fluids and avoid cold water or any other cold products like ice-cream etc.

5) Antibiotics (Preferably levofloxacin 500 mg) would also be a good choice for at least 3 to 5 days course if coughing does not subside with symptomatic medications.

But for antibiotics, you will have to see some local physician or ENT specialist who will know about it and may prescribe it after clinical examination and some relevant tests.

With this treatment,your coughing will improve gradually as the inflammation subsides and which would further help to relieve from chest/body pain.

Hope this will help you.Let me know if you have more questions.

Thanks and Regards,

Dr.Sandip Kabra

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Brief Answer:
fatty liver is reversible.

Detailed Answer:
Hello XXXX,
Thanks for sharing more information.

Certain pain killers (like aspirin) and steroids may cause (but uncommonly) fatty liver but when they are taken for long long time (in years) and definitely NOT by taking for just few days or few months.

So if this is NOT the case of yours then you need NOT to worry about medicines to cause fatty liver.

The most likely cause of fatty liver is obesity,alcohol intake and genetic but unlikely to be due to medicines in your case.

I may agree with your doctor who said NO to medicines to cause fatty liver when detected first time on ultrasound.

Also, it is highly unlikely that fatty liver can cause chest pain,so I will not think about this possibility of chest/sternum pain right now.

This pain could be muscular or musculoskeletal but if you will provide more details regarding pain like..

How was the chest pain started before one month or was there any exaggerating factor?
Was the pain unbearable or troublesome?
Any other symptom associated with this pain?
Have you taken any medications for that?

...with blood reports then I will be able to guide you exactly.

Also let me know that since how many days you are feeling insomniac and tiredness?

Kindly get back to me with these more information.

Regards,

Dr.Sandip Kabra

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Brief Answer:
No need to see doctor at present.

Detailed Answer:
Hello XXXX,
Thanks for sharing your reports.

Your liver function tests are almost within normal limits and marginally elevated SGOT,SGPT and GGT values have no clinical significance or they are likely because of your grade-iii fatty liver.

So,there is no need to see any doctor at this point of time.However below mentioned dietary measures with regular exercises will be helpful as we discussed earlier.

Regular exercise or brisk walk for about 30 to 40 min almost daily will be helpful.

Avoid junk foods and fast foods.If possible make a regular eating habit.

Also take low fat and high protein diet (Veg- Pulses, soyabean and cheese),avoid refined food items like white rice, refined wheat and white bread.

You should take more fresh fruits- vegetables and take simple carbohydrates and better to avoid complex carbohydrates.

Complete cessation of alcohol intake and smoking.

However, there is NO such a time limit on, when to go for a repeat ultrasound scan but it can be repeated after 3 months following above corrective measures and also you should check the liver status with liver function tests (SGPT,SGOT,GGT).

Hope this helps.

Regards,

Dr.Sandip Kabra

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Brief Answer:
Not concerned much.

Detailed Answer:
Hi,
Your blood reports are almost within normal range and some liver function tests are marginally elevated which could be due to fatty liver and has no clinical significance as I already told you.

Let me know if you need more clarifications.

Regards,

Dr.Sandipkabra

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Brief Answer:
No need to worry.

Detailed Answer:
Hello,
Thanks asking again,

If you have noticed clay colored stool occasionally then there is NO need to worry as it may also come during high fat diet or when fat do not get absorbed properly from intestine.

Also the fact that you do not seem to be having any symptoms of icterus/jaundice or dark urine or if so then please with me.

Otherwise there is no need to worry.

If you do not have any more questions then please close the discussion with feed back.

Regards,

Dr.Sandip

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