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Have fatty liver grade 2, LFT shows increased bilirubin, pelvicalyceal fullness, have abdominal pain. Suggestion?

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General & Family Physician
Practicing since : 2005
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Hi, I am detected with Fatty Liver Grade -2 ,and my doctor advised me to do LFT and for the same the result shows BILIRUBIN INDIRECT is increased and its showing 2.00 mg/dl ,rest everything is good .And also there is mild pelvicalyceal fulness noted bilaterally (right>left) He advised me to abstain from Fat Food and all other high calorie content ,and go for a 30 min walk, and from a week i am following the same but still there is little main in my abdomen and also i am not being told by the doc that how much time will it take to get me completely recovered from this problem.Please suggest me on this
Posted Sat, 15 Sep 2012 in Abdominal Pain
Answered by Dr. Prasad 5 hours later

Thanks for the query.

I presume the ultrasound scans and liver profile were done as the consequence of abdominal pain. I can be able to comment about it better if you can detail me the exact location of pain; the type of pain and relation with food and urination. Also let me know whether or not you consume alcohol?

Based on the details provided there are 2 parts in it:
- Fatty liver with increased indirect bilirubin levels
- Mild pelvicalyceal fullness.

1. Fatty liver is an ultrasound diagnosis where there are fat lobules within the liver parenchyma. Grade 2 refers to moderate amount of fat cells present in the liver. This stage is a reversible condition and has good prognosis if the etiology (cause) is treated.
I am not sure about the various etiologies that caused your fatty liver. Perhaps this may be linked to alcohol consumption, obesity, high cholesterol/triglyceride levels and other lifestyle factors. You would need to sit with your gastroenterologist, discuss and undergo few other tests such as lipid profile to determine the cause and take necessary steps to prevent it.

Bilirubin levels are occasionally altered with fatty liver. But high percentage of indirect / unconjugated bilirubin (please verify if you meant direct/total bilirubin and not indirect as you mentioned in your post) with normal liver enzymes makes me wonder if you have an inherited condition as "Gilbert syndrome'. Discuss about it when you visit your doctor the next time.

The liver recovery in the absence of inherited illness can take a few months to years provided the cause is addressed.

2. Pelvicalyceal fullness is noted in the renal system. It is usually associated with a renal outflow obstruction like a stone. It is not that serious concern and so I expect you to recover spontaneously in say 2-3 weeks. Therefore we may repeat the ultrasound scan after 2-3 weeks and an urine test (routine/microscopy and culture) to decide further treatment (if needed).

3. The abdominal pain may be linked to one of the aforementioned organs. Please provide the detailed account to match it rightly.

Hope this information is useful. I await your answer.

Best wishes
Dr. Prasad
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