Brief Answer:
LFTs,Ultrasound,hepatitis profile , workup for the spots/rash

Detailed Answer:
Hello and Welcome

I have read your question carefully and appreciate your concern

Diabetes should be screened by performing Fasting blood sugar and HBA1C levels. Liver function should not be based solely upon physical exam manifestations. An Ultrasound should be done to look for any gross texture changes and any evidence of portal hypertension or obstruction in the biliary tract. Liver function tests along with Bilirubin , Albumin, Pro thrombin levels should be checked for ensuring that the synthetic ability of the liver is intact. Hepatitis profile should also be done. Bilirubin levels if high would present as jaundice on the physical. The skin lesions associated with liver disease are known as spider nevi and appear as part of chronic liver disease. The GERD , dyspepsia symptoms along with gall stones, if present with diabetes present a strong indication for cholecystectomy, to remove the gall bladder to avoid further complications. There isn't one single cause responsible for all of the symptoms but correlations exist between some, for example, the high cholesterol can be related with the gall stone formation but has nothing to do with the fistula, which is an anatomical problem. Please consult your doctor before deciding any course of action.

Let me know if you have any query.

wishing you best of health

thanks
Dr. M.S. Khalil

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