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Suggest treatment for fatty liver disease in an elderly person

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Posted on Tue, 30 Aug 2016
Question: I have an acute very localized pain on the right side under my breast. Drinking alcohol and cold liquids increases or causes the pain. The pain improves with body positions. I have small gallstones that should not cause pain. I also have a fatty liver and high enzymes. I am 57 years old
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Answered by Dr. Bonnie Berger-Durnbaugh (1 hour later)
Brief Answer:
About the right upper quadrant pain:

Detailed Answer:
Hello XXXXXXX

If you have elevated liver enzymes, it is very likely that pain on the upper right side after drinking alcohol could be due to increased inflammation in your liver. High liver enzymes means that your liver is already a bit inflamed. The liver is responsible for breaking down alcohol, and in high enough amounts, it is toxic and inflammatory to the liver. As your liver has some fatty replacement (I don't know how much) and some inflammation (elevated enzymes), consuming alcohol is that much harder on the liver and may be more inflamed as a result.

I am not sure what the mechanism is for having this pain after drinking cold drinks. Sudden cold can cause some muscle spasm but I would not expect it to cause the exact same kind of pain as with drinking alcohol.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh (3 hours later)
Since the pain is in a very small area could it be my gallbladder?
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Answered by Dr. Bonnie Berger-Durnbaugh (13 minutes later)
Brief Answer:
Regarding gall bladder pain

Detailed Answer:
Yes, it is possible that it is your gall bladder. The gall bladder produces pain when there is an obstruction preventing the bile to flow thru. (Also when there is an infection, but then symptoms are more likely to be continuous plus fever.) If your stones have either grown larger, or have caused an obstruction, then they would likely cause pain. But usually the pain happens after a meal with a higher oil or fat content when the gall bladder is trying to release stored bile. An ultrasound can help show what is going on with the gall bladder.

But it is not uncommon for alcohol to cause liver pain when the liver already has some stress or inflammation. A repeat of the liver enzyme tests can give some indication of this.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3138 Questions

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Suggest treatment for fatty liver disease in an elderly person

Brief Answer: About the right upper quadrant pain: Detailed Answer: Hello XXXXXXX If you have elevated liver enzymes, it is very likely that pain on the upper right side after drinking alcohol could be due to increased inflammation in your liver. High liver enzymes means that your liver is already a bit inflamed. The liver is responsible for breaking down alcohol, and in high enough amounts, it is toxic and inflammatory to the liver. As your liver has some fatty replacement (I don't know how much) and some inflammation (elevated enzymes), consuming alcohol is that much harder on the liver and may be more inflamed as a result. I am not sure what the mechanism is for having this pain after drinking cold drinks. Sudden cold can cause some muscle spasm but I would not expect it to cause the exact same kind of pain as with drinking alcohol.