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Abdominal Pain, Done Blood Test And Ultrasound. Kindly Interpret Results

Posted on Fri, 28 Sep 2012

Question: I have an abdominal pain around the central region of the abdominal and the doctor requested me to undergo a blood test and ultrasound scan. The blood test shows low A/G 1.4, high TG 341.0 mg/dL, low HDL 38.7 mg/dL and high VLDL 68.4 mg/d in additon to low Lymphocytes 21%. The ultrasound shows my adominal organs are normal but states my liver is normal-sized with fatty change. Please kindly interpret the results and offer medical advice.

Answered by Dr. Dr.P.Ratnakar Kini (31 minutes later)

Hi,

I am Dr.Ratnakar Kini, Gastroenterologist and I would be answering your question.

I went through your post.

The test report shows you have high triglycerides and VLDL and low HDL levels.

These are part of lipid profile. This test is done to estimate the fat levels (cholesterol and triglycerides) and helps to assess the risk for heart disease. HDL is called the good cholesterol and a low HDL increases the risk of heart disease. Similarly, a high triglyceride and VLDL level can increase the risk of heart disease. In practice, a Total Cholesterol/HDL ratio and LDL/HDL ratio are used to assess the risk of heart disease.

The ultrasound report also says you have fatty liver. It is a condition in which fat is deposited in the liver. Alcohol intake and conditions like obesity, diabetes, high cholesterol can cause fatty liver. Most often, it is incidentally found on ultrasound scan and it is harmless. It reverses once the underlying cause is treated.

I would like to have some more information before I could give my final opinion.

1. How long have you been having abdominal pain?

2. Can you describe the pain?

3. Does food intake worsens it or relieves it?

4. Do you have nausea /vomiting/ loose stools?

5. Does the pain affect your sleep?

6. Are you on any pain killer medication?

7. Do you consume alcohol?

8. By A/G do you mean Albumin globulin ratio?

8. What is the total count of WBC?

Kindly get back to me with the answers to the above questions and I will give my final opinion regarding the symptoms and the tests.

Awaiting your response.

Regards,

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Dr.P.Ratnakar Kini (2 hours later)

Hi Doctor,

Thank you for the prompt reply.

1. How long have you been having abdominal pain?
It has been a week already.

2. Can you describe the pain?
The pain is intermittent and bearable and feels like my intestine is being poked.

3. Does food intake worsens it or relieves it?
It worsens it and I feel like excreting after every meal.

4. Do you have nausea /vomiting/ loose stools?
Loose stools mostly liquid.

5. Does the pain affect your sleep?
Not at all.

6. Are you on any pain killer medication?
I am taking Pantoloc - Pantoprazole and Eldicet - Pinaverium Bromide.

7. Do you consume alcohol?
Yes, I did and frequently until a week ago.

8. By A/G do you mean Albumin globulin ratio?
Yes, exactly.

9. What is the total count of WBC?
10.1

How about the low lymphocytes of 21%?

Please advise.

Thank you.

Best regards,
AAAA

Answered by Dr. Dr.P.Ratnakar Kini (10 minutes later)

Hi XXXXXXX
Thanks for the additional information you have provided.
As mentioned in my earlier post, you have abnormal lipid profile and a fatty liver.

The differential count only indicates the proportion of the various types of white blood cells.

Since you have mentioned you have loose stools and about taking certain medication, I would like to have some of information.

1. Is the loose stool of large quantity/small quantity? Is it foul smelling? Any blood or mucus in it?

2. Stool test done?

3. Do you find relief from abdominal pain after taking the medications you have mentioned?

4. What is the percentage of neutrophils?

Kindly get back to me with the answers to the above questions?
Awaiting your response.

Regards,
Dr.Ratnakar Kini

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Dr.P.Ratnakar Kini (48 minutes later)

Hi Doctor,

Thanks again.

1. Is the loose stool of large quantity/small quantity?
Small quantity only.

Is it foul smelling?
Quite foul smelling.

Any blood or mucus in it?
No, I did not see any.

2. Stool test done?
Not done yet.

3. Do you find relief from abdominal pain after taking the medications you have mentioned?
As the pain does not occur frequently, I feel indifferent about the medication.

4. What is the percentage of neutrophils?
I could not find neutrophils but segmenters 69%, lymphocytes 21%, monocytes 8%, eosinophils 1% and basophils 1%.

Thank you.

Best regards,
AAAA

Answered by Dr. Dr.P.Ratnakar Kini (4 hours later)

Hi XXXXXXX
Thank you for providing the additional information.
Here is my opinion -

1. You have abnormal lipid profile with a probable increased risk for heart disease. You may need medications and dietary modification about which you can discuss with your doctor.

2. You have fatty liver which could be due to alcohol intake and abnormal lipid levels may also be contributing to it. Abstinence from drinking alcohol and treating abnormal lipid levels will reverse it.

3. You probably are suffering from a gastrointestinal infection which might be responsible for the abdominal pain and the foul smelling stool and may explain the abnormal total and differential white blood cell count. A stool test may be done for evaluation. You can continue taking the medications you are already on and may consider taking a course of probiotics.

Does that answer your question?
If there are no more questions, kindly accept this answer and also rate this service.

Regards,
Dr.Ratnakar Kini

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Above answer was peer-reviewed by : Dr. Aparna Kohli