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Dr. Andrew Rynne

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What are the signs and symptoms of hepatitis B?

Answered by
Dr.
Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 1590 Questions

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Posted on Thu, 10 May 2018 in Digestion and Bowels
Question: You can refer the above case of mine as i had already talk with you.
Now i want to share some information.
I had been getting pains under right side under ribs and upper abdomen.
1 month back - I had throat pain,body pain and mild fever so i had been to doc and he gave me Azithral for 5 days 1 each and citrizin
after that i got throat pain and mild fever again after 2 weeks the i took rem cc Tab for 5 days and all these i felt like bloating and gas
the 5 days back i had more pain in center of stomach,upper abdomen,nauseating feeling,lots of gas,yellow stool and then i when to doc he told to take taxim Oz and pre pro IBS and i better now but still have nauseating feeling
I have one more question - I was having a constat weight of 79.8Kg and last month before geting fever i was 79.3 and last 4 weeks back i was 78 - i am scared if this is due to hep b please advise
Please advise me i am scared now of Hep b again?
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This is XXXXXXX 28 Years old and would like to describe the events to you and need you advice as I have been most disturbed post this event in my life it’s been 9 months I am still tensed and lost in world. I am too scared to get a blood test done for Hep bas I fear.
On night 15 XXXXXXX 17 - I had my first ever sex encounter. It was a protected sex with CSW for a less half a minute - Just an intercourse and I nothing else as I was very scared. Post this I was googling and got mentally disturbed with HIV and Hep B
Then on 20 May till 22 May - I last had Non veg food on 1 XXXXXXX 2017 and was not been having non veg and alcohol for 4 months till 20 May, but on this day I had Chicken in a regular Dhaba I use to visit and have a Strong Beer – felt heavy gastric and fullness in stomach already and bloated. Note: I have always had this Gastric problem coming and going - Bloated, acidity, burning sensation in stomach, acid regression as my life style is of software engineer and no Physical activity and had more chicken and more beer and whisky at same place with having gastric symptoms like passing fouls smelling gas and the stool was shiny and soft with light Yellow with some pungent smell
On 23 May - Now I had mucus in my stools and it increased a little more next days - No loose motion. But I use to Pass gas and stool both at a time and I saw the stool very closely it was having a little pink I think it was blood and got panicked also started to had pains/cramps (I don’t know what was it) in both sides of stomach hip region and sometime pains in centre of stomach coming and going.
Then Again on 26 May i had lots of stomach bloating as I had skipped meals as I was not hungry and built more gastric but I had more beer and smoked more and had vomiting sensation – stools was loose and saw a light red / pink and I am sure it was blood again I had pains in side of stomach and centre and below right ribs ( I was very scared as I had read it has liver on the right side of body) and sometimes I had pains left ribs also (sensation and cramps in sides of stomach) and burning sensation in anus and feeling of sum thing coming out after passing stools and randomly. Then I went to General Physician and told him all these - he told I have IBS and gave me prePo IBS for 6 days and then I was taking it and mucus stopped by stools also were hard.
On 30 may - I was not feeling hungry and had the same feeling of pains under rib and sides of stomach went to same doc he advised me to take TAXMIM 1-0-1 OZ - 5 days with PrePro IBS tab as I had some infection he told. And my urine is all fine and no yellow and he advised me to take Liver function test and abdominal scan.
14 Jun – As per Doc - I took the tests and I have attached the Liver function test report and 1 week back I took the abdomen scan and it was normal with just fatty liver observation.
From past some months the pain and craps have reduced. Some days again now it has again started to feel pains below my ribs on the right side coming and going even now randomly sometimes. I don’t know what it is.
Also 4 weeks back I had mild fever twice and throat infection doc told we to take azithral for 5 days and I felt lots of gastric post that
Past 2 weeks I am feeling more pains in centre of stomach after food, Nausea feeling, pain in upper abdomen, more bloating and yellow soft loose stool I went to doc and he told Taxim OZ again, pre pro IBS. But I am feeling ok now but I still have Nausea feeling. Please advise me I am goin scared of Hep b
Even my stool colour keeps changing to yellow and now it’s very dark brown and green (loose some time and hard)?
I keep reading and always check Hep B symptoms on internet and I am very disturbed and unable to work at office. I am losing my mind. Please help me relax my anxiety as I am fearing Hepatitis because I had sex with CSW and read on google it can come through sex. Its 9 Months past after exposure about am totally scared reading google – request you to help me
Can you provide the expect advise on my risk of Hep b?
As its 9 month after exposer -When do people get symptoms for hep b infection?
Should I stop worrying?
Lastly - From many years weight was 79.9 and 4 weeks back when I checked ist showing 78.3 and today I checked its showing 77.4– is it because of Hep b as I have read on google it cause weight loss.?
doctor
Answered by Dr. Ramesh Kumar 3 hours later
Brief Answer:
Start selective seretonin reuptake inhibitors.

Detailed Answer:

Hello,
Thanks choosing HealthcareMagic for your query.
Have gone through your details and i appreciate your concerns.

Semen, vaginal fluids and anal canal tears all contain the hepatitis B virus (HBV), and the higher the viral load, the more infectious one’s blood and body fluids are. So its not necessary that even if you had sex with a hepatitis B patient you would get it.It fepends on the viral load of patient.So the rule here is unless you test positive for the hepatitis B surface antigen (HBsAg), you are not infectious.Anal sex carries a very high risk of transmission because of tears in the skin that can occur during penetration improves transmission of HBV.Protected vaginal sex is rarely involved in transmission.

10 weeks are required for hepatitis B to become symptomatic.

Yes you should stop worrying.However i think that you need to have some medications to stop making you obbsessive toward it.
Take Paroxetine 25 mg once daily for 3 weeks.Its a SSRI and would help you with your obbsession.

Weigh loss in hepatitis B is drastic for eg you would loss 5 kg in 4 weeks.

1 or half kg difference can be due to machine error weight of clothes etc.


Suggestion
Start paroxetine therapy for obsession.

Regards!
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ramesh Kumar 2 days later
Hi Doctor,
Thank you for your response and guidance.

I have started take the tab you have mentioned and I am taking it in the morning is it fine after breakfast?

Last follow up questions and I will not ask you anything more regard to my symptoms and just listen to you and follow up. I have just kept my faith on you Doc.

1. As I am writing to you now and it started from Yesterday after I had a glass of Water melon juice without stain - I got Sharp Pains and Burning sensation in centre of Stomach, more of bloated feeling and it’s still not reduced and also the burning sensation is still lower abdomen around my bladder area and sides of front part of hips and urge to pass stools. Can you please help me with this? Is it due to the Juice? How to reduce it and reason for it?

2. Just last week I had been to my GP and told him for intermittent pain in centre of stomach and fullness in upper abdomen, Nausea feeling before and after food with Yellow, loose and smelly stool he told me - to take Taxmin OZ for 5 days 1-0-1 and enterogermina 1 daily for 5 days and pre Pro IBS but that has not helped me much and now I still have this burning sensation in stomach and pains. Please advise me as you’re a gastro expert and the Doc I show is and ENT surgeon and a GP. Twice in the past I had gone with this complaints and he’s has given be the same med. Your thoughts?

3. 1 Month Back when I when to doc for Flu and throat infection he gave me Azithral – 5 days 0-1-0 and 3 days of dolo 650 1-1-1 , Again after taken it refunded back and gain g the doc told me to take Tab Rem cc for cold. Do you think these would be the cause for the stomach problem I am having now? I had taken lot of Antibiotic dose Can you advise me as why I have been getting these symptoms and stomach related regularly? Should I take any gastro check-up? You alone can help me Doc.


doctor
Answered by Dr. Ramesh Kumar 6 hours later
Brief Answer:
Once obsession and anxiety is controlled you would feel much better.I think its OCD with gastritis.

Detailed Answer:
Hello again my dear young friend.
Please feel free to ask whatever you want.Its a pleasure to help you.So you can follow up whenever you want.
1)Sharp pain and burning sensations are frequently encountered in patients with gastritis or acid peptic problem.Most of the fruit juices are citric in nature therefore they can cause irritation of mucosa of gut causing heartburn and pain.

Suggestion-
Take Cap Rablet L(rabeprazole and levosulpiride) once daily for 5 day.
It would take care of acid and bloating.



Tell me how you feel after 5 days(acid peptic pain usually responds to it).

2)Going by history it can be IBS But if we follow response to medication it seems more like gastritis or acid peptic disorder.
You have to take medications for 5 days initially and only after that i can make any further comment.


3)Initially follow-
Take Cap Rablet L(rabeprazole and levosulpiride) once daily.
Tab Pexep Cr 25 mg once daily.
Tab Etizolam 0.25 mg once daily (These are available on prescription)
Follow up after 5 days.It would make things clear.
No investigation suggested right now.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramesh Kumar 3 days later
Hi Doc,

Thank you for time and patience.

1. Sir - As per ypur advise I was took Drego - D early morning before break fast for a day and next day when i went to ask for Rablet - L they told me my area their was no Rablet - L stock? can i continue Drego -D or Take Rablet - L - for 2 days i took Drego - D i dint find much effect - Today and yesterday i din take Please advise me .

2.As i am writing this, i am having tightness in my center of chest/Abdomen from past 2 days and it vanished on its own and from night yesterday till now i am having the tightness - please help me relive this or give me a suggestion to feel better now as their are doctors around in my area as its a Saturday and Sunday tomorrow - I request you to help me ASAP.

3.I have been seeing the stools and today as from past also i had my stool Light/pale yellow or some times dark Yellow (Soft)?

doctor
Answered by Dr. Ramesh Kumar 4 hours later
Brief Answer:
Follow up.

Detailed Answer:
Hello dear.

As explained earlier by me earlier you need to take SSRI’s and Etizolam.
Just taking Drego D won't help.

You need to take all three medicines as prescribed by me for 2 weeks.
In just 2 days, I don't feel you would be relieved.
Things will take their time.

Have you started Pexep cr?
Have you taken Etizolam?

Awaiting....


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Ramesh Kumar 17 days later
Hi Doc - I am back for your advice and help as

Please answer me with your best of the knowledge

1. Today i am totally shattered seeing my LFT report taken today as ALT and AST are more, is it Hep b should i worry about hep b i am totally lost ? please help me as you are expect attached reports taken today

2 .two weeks back i had been to a famous Gastro doc and told i have fatty liver and.He suggested me to take Endoscopy and Sigmoidoscopy. As per the report of Endo it showed a ulcer near duodenum and Sigmoidoscopy showed mild hermatoides. Then he advised me as i have mild duodenitis and asked for a biopsy ans it showed as chronic duodenitis and doc told nothing to worry and just gave Medicines NES ES 20 1-0-1 and ISOZEX 1-0-1 for 50 days. i am feeling better now

But doc i want your verdict on this. what do you think of the above?
doctor
Answered by Dr. Ramesh Kumar 9 hours later
Brief Answer:
Follow up.

Detailed Answer:
Hello Mr XXXXXXX
I have gone through the repors attached by you.
Firstly i would say that mild derangement of liver functions have no clinical significance.Minimum three times elevation of liver enzymes should be there along with clinical symptoms for having any significance for physician.So i din’t feel that you need to panic.Infact a variation of 5-10 IU can be seen if the same test is repeatd at any other lab.
Dear patient a doctor never treats numbers rather we treat symptoms.In a a symptomatic patient the above attached report has no significance.

As per the query regarding Hepatitis B is concerned go for a serum serology test(HbsAg) and things would be clear.
My dear patient duodenitis gastritis peptic ulcers all of them are inter related terms and are caused as a result of acid peptic disorder overlapped with anxiety(It stimulates vagus nerve).
If there is inflammation in duodenum we call it duodenitis.
If inflammation extens to stomach its gastritis.Constant inflammation and irritation by acid causes breaching of gutwall causing ulcers.So as you can see all are related to each other.

Hemorrhoid on the other hand is a problem related to mucosa of lower intestine.

My suggstions are-

Suggestion for conservative management are-

Start taking Syp. Lactulose 10-15ml once daily before going to bed. It is a laxatives, tolerated very well by patients in long terms with minimal side effects.
-Secondly, start using PreprationH a combination of Calcium Dobesilate, Hydrocortisone, Lignocaine, and Zinc.


Add Fybrogel to your regimen. It's a natural laxative and a bulk forming agent.It absorbs water from the intestine and swells up making passage of stool easy and add bulk to stool.

-A probiotic should also be taken regularly with these medicines. Probiotic improves overall digestion and relieves constipation.


Hope i was helpful..


Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Ramesh Kumar 1 hour later
hi doc

thanks for your advice and patience.

just follow up questions
can u please help me understand why other parameters are fine and only alt and ast are little elivation? do you think it's hep b as ur an expert I need you explanation on if it's hep b or not as I am so scared and not will to take a test for fear.
2. it's almost 10 months of exposure to protected sex can now there be chances of hep b showing up in LFT?
3. 5montha back I had taken LFT report and all were normal and gastro doc told me my alt was just 4 numbers less then 4 numbers normal readings as told u have fatty liver and told me not to eat hinon veg. I have been having fatty liver from 5 years but last 5 months back and now I took LFT reports now and it's showing a increased alt and ast why is it increaseing from past to now the alt and ast
4.as per this report can u as per your experience rule out hep b as it's 10 months exposure my family and I am feeling lot of stress sir please help me
doctor
Answered by Dr. Ramesh Kumar 6 hours later
Brief Answer:
Follow up answer.

Detailed Answer:
Hello again my young friend,
I have gone through all your attachement's and i can't find any thing which isd clinically significant;All parameters except ALT,AST are in normal limits.AS explained earlier ALTand AST are also marginally elevated i would again repeat that minimum three times elevatuion then maximum normal range has any clinical significance,By that i mean that if normal range of a particular enzyme is 20-40 then for us to suspect any problem its level should be minimum 120(with symptoms).

Dear patient no one can say whether you are hepatitis positive or negative by physically examining you or by going through attached reports.As told earlier my dear you should get a test named HbsAg done.After that only one could say if you are hepatitis b positive or negative.However going through your reports i don't feel that you have any problem related to your liver(caused due to viral infection).

As told earlier i don't feel that you have hepatitis B neither symptomatically nor going through your investigations rather you are too obsessed by fear of having hepatitis b or liver problem.

1) LFT is just a basic test my dear.For eg if you want to learn english you have to learn ABCD..in the same way when we talk about liver LFT is the basic test hoever unless and until its severely deranged(asl,alt more then 5-8 times,Bilirubin more then 5-6 mg/dl) no one could predict your virology.

3)Repeat LFT at 2 different labs and you would see a variation of (plus minus 10) ,Do it yourself and see.Dear patient we can't treat numbers we treat symptoms and treatment.

4)From my point of view mild deranged LFT is due to fatty liver and has nothing to do with hepatitis etc.
Sexual transfer of Heptitis B and H.IV are overhyped. Its rare otherwise every person in thailand or combodia etc would have hepatitis and hiv.
Have you started taking Paroxetine?
Hope i answered your query well.
Please follow up if you have any confusions.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ramesh Kumar 42 hours later
Good Morning Doc!

Thank you so much for advise. you always make me relaxed and reduce my tension.

Just some questions.

1. As per you knowledge Hep B via sexual transfer is a over hyped - Can i know why do you say that? can you share your knowledge for me to understand,because when ever i see Hep b in google or talk about this they tel its mainly through sex and blood transfer. do you have a statistics for hep b via sex transfer as per your live experiences of your long carrier as a doc?

2. I had been to the same doc yesterday and he a famous doc in XXXXXXX and told me just to take HEPAXIDE 300 1-0-1 for 2 months and told its because of fatty liver - is the doc provided me correct guidance? also i just told him a hint about me 10 months back i had been for a massage at spa and he just laughed and told if its unhygienic also you are just a young man and nothing to worry bout hep.

3.I have been getting pains under right ribs from many days and some days it was not their at all as i started to take tabs given by gastro - (ISOZEX and NEX ES 20) and isobogul but from 3 days now again started like pains coming and going in upper abdomen,center of stomach,i feel like pain in back exactly where their is liver. Can you explain me how a liver pain will feel and is this pain i am getting is because of ALT and AST elevation ? or is it because of chronic duodenitis ?

Thanks fro your time for answering all my question with great patience.
Hi Sir,

please provide your responce when your free
doctor
Answered by Dr. Ramesh Kumar 11 hours later
Brief Answer:
follow up.

Detailed Answer:
Hello again,
1)Though million of people are having unprotected sex every day the number of hepatitis positive patients are less.
Practically have you ever seen some one having hep B positive in your friend circle or people you know.
Million of patients are having blood transfusion daily but do you know any one who has got HIV or Hepatitis B after having blood transfusion?

Your gastro has given you a liver rejunuvator antioxidant and you can take it.

I dont feel your pain is related to liver.
Again as i suggested earlier you should start SSRI’s.
Regards!
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Ramesh Kumar 13 hours later
Hi Doctor,

Good Morning! Thank you for the time you spent on my questions all these days.

My responces.

1)Though million of people are having unprotected sex every day the number of hepatitis positive patients are less. - OK i understand. have you seen the transmissions patterns of Hep b infection as a doctor? i mean practical Facts.

Practically have you ever seen some one having hep B positive in your friend circle or people you know. - I have not seen any one like that but i had my uncle who passed away at around 62 with hep b.The memory haunts me. You should tell me and advise me

Million of patients are having blood transfusion daily but do you know any one who has got HIV or Hepatitis B after having blood transfusion? I dont know Sir - You should tell me and advise me but as per people and internet CDC and other trusted sites always hep b transmission mode is give as sexual contact? your thoughts

Your gastro has given you a liver rejunuvator antioxidant and you can take it. ok agree. i will continue

I dont feel your pain is related to liver. ok sir - Can i know who the liver pain would start and feel like just curious
Again as i suggested earlier you should start SSRI’s.
- I hav already started with you medications as per the psychiatric doc i consulted

I will close the thread at this note - I have never seen a doctor so humble and supportive like you. I will always remember you Sir my deep regards. Thank you so much to have helped me while i am in pain.
doctor
Answered by Dr. Ramesh Kumar 5 hours later
Brief Answer:
follow up.

Detailed Answer:
Hello again my dear patient,
I can very well understand your concern but see fact is that most of the people who are surfing a particular disease or writing about it on net are usually suffering from a particular disease and are either not managed properly or are defaulters in treatment or relapses etc.
I would give you a example,When ever a patient comes to a doctor doctor always suggest them that if they are cured then they should visit back once before discontuing the medications but as a mater of fact 99% of times only those not relieved by medication comes back.
In the same way you can read a lot of panicking stories about hepatitis b on various forums because only a person who is in suffering would have time to write reviews and all.Therefore don’t unnecessarily google too much and have my word you don’t have hepatitis.

Please feel free to follow up and good luck.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ramesh Kumar 19 days later
Hi XXXXXXX Sir!

hope you are well. Thanks for your message.you have till date give me best advise like a guide and XXXXXXX I have come to you with more questions. please help me

1. I am taking the tabs as per hepatologist advise . ISOZEX (1-0-1), NEX ES 20 (1-0-1) and Hepaxide 300 (1-0-1) and isobogul for 2 months. its been 1 month completed. as i had been told i have chronic deodentis . is this correct to take these tablets your thoughts please

2. As per my LFT report on 15 Nov ALT and AST were little elevated attached report , so the Doctor told me i have XXXXXXX and gave me Hepaxide 300 for 2 months. Can you advise me if this a correct as per your thoughts. will my LFT be normal after completing 2 months course? has the doctor dioganised me properly?

3.After taking Hepaxide 300 i am feeling lot of nausea and stomach burring ,pains in and around center of stromach which comes and goes, stomach pain ? is it side effect of the tablet?

4.last question, I am geting pains around my right side below ribs, some feling of cramps like and sudden pains on ribs esp. right side and back side, i am scared if my elevated ALt and AST is causeing this my pains ? please help me understand

doctor
Answered by Dr. Ramesh Kumar 17 hours later
Brief Answer:
follow up.

Detailed Answer:
Hello dear,
Thank you for follow up.
Hope you are doing fine now,
Extremely sorry for a bit delayed response.
Can you please name the salts in the medication written by you.Actually brand name varies from country to country abd city to city.
So please pen down the salts in these medicines.

I can’t find composition of Hepaxidr on google.Please write down the salt.

waiting.
Revert back asap.

Thanks!
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramesh Kumar 34 minutes later
No problem Sir for the late responce.

Below is the complete composition of all the tabs and doesages

1.ISOZEX -( 1 - 0 -1 ) - ISOPROPAMIDE - 5 MG AND TRIFLUOPERAZINE 1MG

2.NEX ES 20 ( 1 -0 -1 ) - ESOMEPRAZOLE IP 20 MG

3.HEPAXID -300 ( 1-0-1 ) -URSODEOXYCHOLIC ACID IP 300 MG
doctor
Answered by Dr. Ramesh Kumar 54 minutes later
Brief Answer:
follow up.

Detailed Answer:
Hi dear,
Trifluoperazine is a anti pyschotic and has been given to you to calm down your brain.However its used in schizophrenia.What i feel is that you are not schizophrenic rather you are obsessive and so this is not the right medicine for you.
I would suggest you to go for Paroxetine 25 mg to be increased to maintainence dose of 50 mg once daily for 4 weeks.(prescription medicine)
This medication works very good on obsession.

Rest all medications are fine.
Urodeoxycholic acid is a very safe salt and is not usually associated with side effects you are feeling.
Frankly speaking my dear i would suggest you to start paroxetine and an anxiety medication like lorazepam along with it.You would start feeling better in few weeks.

You LFT is not the cause of your problem.

Thanks!
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Ramesh Kumar 20 minutes later
Hi XXXXXXX Sir !

Thank you so much!

I have some more questions.

1.As per my endoscope they told i have chronic deodentis ( ulcer)? Can you please talk about this?
How it has happned, duration of cure any natural cure? how to manage this?

2. As per my LFT report on 15 Nov ALT and AST were little elevated attached report , so the Doctor told me i have XXXXXXX and gave me Hepaxide 300 for 2 months. Can you advise me if this a correct as per your thoughts. will my LFT be normal after completing 2 months course? has the doctor dioganised me properly? Do you think its XXXXXXX and not viral heptasis ?


3.last question, I am geting pains around my right side below ribs, some feling of cramps like and sudden pains on ribs and under esp. right side and back side, i am scared if my elevated ALt and AST is causeing this my pains ? Please help me understand about liver pain and is this not related to liver pain?
doctor
Answered by Dr. Ramesh Kumar 4 hours later
Brief Answer:
follow up.

Detailed Answer:
Welcome back,

1) If you have ulcers then start taking Sucralfate 1gram thrice daily for 1month.They are ulcer healing agents and would heal up gut mucosa.

Secondly, anxiety stimulates the vagus nerve which leads to secretion of a large amount of acid in the stomach. This acid further increases the problem of ulcers.
Duration of cure depends on how well we control your anxiety levels along with ulcer healing medications.

Management-
Tab Pexep CR 25 mg once
Tab Lorazepam 1mg once
Tab Sucralfate 1 gram thrice
Tab Isopropamide 5 mg twice
This is for your ulcer part. Please obtain the necessary prescription for these.

Natural cure is lifestyle changes-
Do not lie down for 2-3 hrs after eating.
Avoid acidic foods - citrus, tomatoes, juices
Decrease caffeine (colas, coffee) and sodas in general.
Decrease alcohol or completely stop it.
If you smoke cigarettes, now is the time to stop. They increase acid production and delay healing.
If you are overweight through the middle, that increases the risk of reflux. Try to decrease your weight (if overweight) slowly over time.

Eat smaller amounts at a time so there is less pressure in the stomach which can reflux acid into the stomach.

Avoid eating/drinking mint (it relaxes the lower esophageal sphincter which can allow more acid up).

It may not be viral hepatitis as you are not having hepatitis A or B infection. Mild elevation of liver enzymes is due to fatty liver changes.

Ursodeoxycholic acid is a good choice.
Tab liv 52 ds(Ayurvedic formulation) can also be taken along with it.
Sylimarin a liver tonic can also be added for fast and better results.

Pain due to liver usually is felt in right upper quadrant and usually, there is no radiation. Your pain seems more likely due to peptic ulcer dear.

If you would follow proper medication with lifestyle changes it would settle down.

Regards!
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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