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What Causes Mild Pain In Right Upper Quadrant In Patient With NAFLD?
Question: I am JAI , 46 years of age and suffering from NAFLD for the last 10 years. For the last two months there is some uneasiness and mild pain in my right upper quadrant and I consulted a gastroenterologist for the same. I was tested for hepatitis B and C both negative. My LFT showed the following values- total bilirubin 0.5 mg/dl, SGPT 73 U/L, SGOT 52 U/L, Alkaline phosphatase 109 U/L. Albumin 4.4g/dl, globulin 2.7 g/dl. USG mentions" liver is normal in shape, regular smooth outline and of hyperechoic homogeneous echotexture. No focal parenchymal lesion, intrahepatic bilary radicles are not dilated, branches of portal vein are normal. Impression..diffuse fatty changes in liver. Lipid profile test showed total cholesterol 197mg/dl with HDL 37 mg/dl, HDL 145 mg/dl, VLDL 15 mg/dl, triglycerides 176 mg/dl. The gastro ordered a alpha feto protein test.....reading was 1.93 ng/ml. My co morbidities include hypertension, mild blockage in LAD (CAD) and medications include sartel 80, prolomet xl 50, aspirin 150, deplatt 75 with nitrocontin 2.6 SOS. I am obese with a weight of 220 lb for 182 cm frame and there is median obesity despite the fact that i take small restricted meals. I am a smoker who failed to kick this habit. The gastroenterolongist concluded that I will develop cirrhosis in 3-4 years and gave me a supplement of Vitamin E. I am at a loss and unable to understand as to how he can predict cirrhosis in 3-4 years without assessing the underlying stage of fibrosis. What are my options? What should I do?
Brief Answer:
Liver biopsy is more an accurate tool to predict fibrosis.
Detailed Answer:
Hi Sir.
I understand your concern.
I have gone through your reports in detail.
Your doctor might have given his predictions based on NAFLD score.
In NAFLD,the risk of fibrosis and Cirrhosis can be assessed through NAFLD Fibrosis Score calculator.
Its based on albumin,platelet count,SGPT,SGOT ,BMI,values.
Based in these values the predicted score in your case is around 1.7 which indicates stage 3/4 fibrosis,which can possibly turn cirrhotic in 3-4 years.
But NAFLD score is not the accurate prediction tool.
Liver Biopsy is the accurate staging tool and predictor of cirrhosis.
There is no specific medical therapy for NAFLD.
Only 10-20 % will go onto develop Cirrhosis and subsequent malignancy.Hence a periodical scan is necessary.
Weight loss,Vitamin E ,Atorvastatin,Pioglitazone are the known drugs that are proven to delay the progression of NAFLD To Cirrhosis.
Post your further queries if any.
Thank you.
Liver biopsy is more an accurate tool to predict fibrosis.
Detailed Answer:
Hi Sir.
I understand your concern.
I have gone through your reports in detail.
Your doctor might have given his predictions based on NAFLD score.
In NAFLD,the risk of fibrosis and Cirrhosis can be assessed through NAFLD Fibrosis Score calculator.
Its based on albumin,platelet count,SGPT,SGOT ,BMI,values.
Based in these values the predicted score in your case is around 1.7 which indicates stage 3/4 fibrosis,which can possibly turn cirrhotic in 3-4 years.
But NAFLD score is not the accurate prediction tool.
Liver Biopsy is the accurate staging tool and predictor of cirrhosis.
There is no specific medical therapy for NAFLD.
Only 10-20 % will go onto develop Cirrhosis and subsequent malignancy.Hence a periodical scan is necessary.
Weight loss,Vitamin E ,Atorvastatin,Pioglitazone are the known drugs that are proven to delay the progression of NAFLD To Cirrhosis.
Post your further queries if any.
Thank you.
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Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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