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Taking medicine for diabetes and BP. Have swollen ankle. Ultrasonography done. Worried for cirrhosis

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Gastroenterologist, Surgical
Practicing since : 1986
Answered : 38 Questions
Dear Dr. Patta,
I have a query regarding my father's health. He is a diabetic since 1989. He is taking insulin for that and the sugar level is now in normal range. His creatinine levels are slightly elevated at a level of 2.9, hence the doctors in St. John's Hospital in Bangalore has commented on slighlty slow performance of the kidney. He is also taking blood pressure medicines. Also, the tests show a high loss of proteins through urine. His legs specially near the ankle are swollen. Recently his ultrasonography diagnosis have shown the following:
1) Coarsened echotexture in the liver
2) Slightly shrunken left lobe of liver
3) Few nodular contours
The endoscopy has repoted
1) Early esophageal varices. 4 colums are seen
2) Duodenitis
But his blood reports are showing:
1) Normal Bilurubin amount
2) Platelet count of 1.2 lakhs
3) Normal ALP and AST values
4) Vitamin D deficiency
5) Hepatitis B and Hepatitis C negative
Apart from this he has an urinary infection due to the bacteria Kleibsilla.

Please let me know, whether he is suffering from cirrhosis or not? If so, then what should be treatment procedure for that?

Posted Tue, 19 Mar 2013 in Abdominal Pain
Answered by Dr. Radhakrishna Patta 10 hours later

Thanks for writing to us.

I understand that your father is diabetes and currently receiving insulin. In addition, he also has early diabetic nephropathy.
In addition from the reports you've mentioned in the mail suggest that he also has evidence of cirrhosis of liver which could be cryptogenic ( cause not known if he is not an alcoholic) In cirrhosis the SGOT / SGPT / S.bilirubin all can be normal. Only the serum albumin may be low.
He will require treatment for his cirrhosis right away in the form of salt-restricted diet, medication to reduce portal pressure, avoiding constipation etc..
His diabetic nephropathy needs to be monitored by a nephrologist and his cirrhosis by a gaastroenterologist.

Above answer was peer-reviewed by
Follow-up: Taking medicine for diabetes and BP. Have swollen ankle. Ultrasonography done. Worried for cirrhosis 9 hours later
Dear Dr. Patta

Thanks for the prompt reply.

Yeah he has never taken alcohol, but in his childhood he had a jaundice attack.
Serum Albumin is not yet tested, but yeah albumin in urine is reported as " Present (+)".

Also regarding the varices, which are mentioned as early, I would also like to mention that no bleeding has been observed in his stool or urine. Moreover, his portal vein measures 6 mm in ultrasound.

Also the primary biopsy duirng endoscopy has reported presence H.Pylori bacteria.

Currently he's taking low salt and low oil diet. Also he's seeing the medical specialists, you have suggested.

He was having constipation, but not a severe one. Now after the diet, his constipation apperas to have gone.

Even if he has cirrhosis, what stage do you think it is. Is it curable?
Answered by Dr. Radhakrishna Patta 50 minutes later

Thanks for your revert. I think your father has early cirrhosis with well-preserved liver function. I suggest he be under constant surveillance of a gastroenterologist.

Above answer was peer-reviewed by
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