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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What might the following be suggestive of: Enlarged liver ,

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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2040 Questions

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Posted on Sun, 13 Jan 2019 in Digestion and Bowels
Question: What might the following be suggestive of: Enlarged liver, feeling full after a very small meal, some weight loss, blood work normal EXCEPT: Low BUN/creatinine ratio, low calc osmolity, and low platelets? This is regarding my husband, 65 years old, history of terrible decades-long reflux off and on, mild to moderate drinking occasionally since 20's (not daily, and only beer). He feels pretty good generally. He has obviously lost muscle mass. He just had a liver scan, no results yet.
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Answered by Dr. Ramesh Kumar 1 hour later
Brief Answer:
Hepatic steatosis most likely.

Detailed Answer:
Hello and Welcome to 'Ask A Doctor' service.
I have reviewed your query and here is my advice.
His symptoms can be a sign of hepatic steatosis. In easy words it could be suggestive of mild fat deposition in liver termed as fatty liver.Most like he is having non alcoholic age related fatty liver.As age of a person increases fat began's to accumulate in various parts of body like blood vessels(atherosclerosis) or liver(fatty liver),Its very natural and a part of process called aging. However in some patients usually obese,drinkers or adults these changes may be there more frequently.
The amount of fatty acid in the liver depends on the balance between the processes of delivery and removal.As the age increases the number of transporter cells which carry fat from liver to peripheral parts(for utilization decreases);Causing increased deposition of these fatty acids in liver.
Liver produces many enzymes and hence loss in appetite could be due to fatty liver.As appetite loses lean muscles would be lost.He should take liver rejenuvators like milk of thistle and antioxidants daily.External digestive enzymes could also be taken.
low BUN/creatinine ratio etc could be a sign of poor blood supply to kidney.Blood is pumped into body by heart.As described above atherosclerosis of heart and kidney could be responsible for that.
As he is 60 few tests should be done-
Scan of liver-reports awaited.
Renal Doppler to look for blood supply and kidney functions.
Ecg and 2 d echo to look for proper functioning of heart.
Mild decrease in platelets make no clinical sense however if platelets are less then 1.5 million/mm cube then mention.
Follow up with reports of ultrasound.
Thanks
Above answer was peer-reviewed by : Dr. Prasad
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