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Dr. Anil Kumar
Dr. Anil Kumar, General Physician
Category: Health
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Experience:  M.D. with over 30 years of experience in practice.
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I will try to be as brief as possible.In August 2012 (~9 mos

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I will try to be as brief as possible.In August 2012 (~9 mos ago) I had an ultrasound done that showed my liver had echogenic characteristics/ 'compatible with fatty liver'.Prior to this ultrasound in the years of 2010-2011 I had 6 ultrasounds andXXXXXscans (for acute appendicitis) at which time did NOT reveal the fatty liver, so I am assuming it was NOT present until August 2012. To give you the background at the time of the ultrasound I was 232 lbs, high cholesterol/high triglycerides, and pre-diabetic. However, all other bloodwork was absolutely normal (liver enzymes, and other hepatatic labwork). Since August I have lost 35 pounds (now 196 pounds) and still trying, I am trying to exercise as much as I can, I do not drink (was an occasional social drinker) and have started a cholesterol med that has lowered both my LDL's and triglycerides. My sugar has gone down as well. I take omeprozole (GERD), Prozac (20mg for GAD), Prevastatin (40mg for cholesterol), and Zyrtec (10mg as needed for allergies). I also take Vitamin E, Calcium with vitamin D, and a liver support supplement. I have cut out most white starchy carbs, fried foods, high fat foods, sodas, beef, and junk food. I need to lose at least 50 more pounds and I intend on doing it. This is my question... I am still worried that I am not doing what I need to do to reverse this condition. I see my PCP every 3 mos, have labwork done at same time, and follow her advice as best as I can. She said there is no need for a follow-up ultrasound nor to see a specialist. The mild discomfort I feel at times on my right side she has no worries about, yet I do. It may be muscular in nature because I have back issues, but I am concerned it is my liver inflamed. I am doing everything I can to be proactive about this condition, but it is a slow process and I am concerned that I, or my doctor, may be overlooking something. If you could address my concerns with your advice I would be very appreciative.
Submitted: 1 year ago.
Category: Health
Expert:  Dr. Anil Kumar replied 1 year ago.

Hello,

I understand your concern.

And firstly i appreciate your efforts to keep you healthy.

Now as you are worrying about echogenic liver with compatible to fatty liver so this could be caused due to high triglycerides,Obesity,Alcohol intake.

And as your hepatic blood work are fine now so i want to assure you that this echogenic liver can be reversible.

However it takes few months to recover again by it's own.

As you have lose weight,quit alcohol and reduce fat rich diet so these are good lifestyle modifications.

If you are still unable to lose weight then you should ask your doctor for Thyroid function test to rule out Thyroid dysfunction.

Also ask for FDA approved weight loss pill-Orlistat.

And continue to get repeat blood work every 4 months.

 

I hope this helps.

Please rate me highly (Star 5 Great Service), if you are satisfied with our conversation.

If you have any further query then feel free to ask.

Bonus and positive feedback are highly appreciated.

Good Luck.

Thank you.

 

 

Customer: replied 1 year ago.

So you see no need for a follow-up ultrasound nor to see a specialist?


 


The mild discomfort I feel at times on my right side is not ominous of something worse?


 


Supplements and medications ok to take? Not harming my liver further? Is Orlistat a prescription?


 


I am scared this will progress to cirrhosis or liver cancer?

Expert:  Dr. Anil Kumar replied 1 year ago.

Hello,

Thanks for the follow-up.

You should continue your Supplements and medications as such for next 2 months.

And get a repeat blood work and if everything is fine then you should ask your doctor to adjust dosage of your medications.

You need to keep control over your diet and lifestyle modifications which are best for you.

As you feel mild discomfort in right side so i would also advise you a follow-up ultrasound in next few months.

You can consult a Gastroenterologist as well.

The drug Orlistat is currently available over the counter, under the brand name "alli", in the US, Australia, and Europe.

However it is advised to consult your doctor first before starting it.

You shouldn't worry about Liver cirrhosis and cancer as chances are less in your case.

 

 

 

 

I hope this helps.

Please rate me highly (Star 5 Great Service), if you are satisfied with our conversation.

If you have any further query then feel free to ask.

Bonus and positive feedback are highly appreciated.

Good Luck.

Thank you.

 

Customer: replied 1 year ago.


What would the follow up ultrasound be useful in doing?


 


I have a GI doctor whom I saw in October this year and he evaluated me and because I had a colonoscopy and upper endoscopy in October 2011 he saw no reason to do anything.

Expert:  Dr. Anil Kumar replied 1 year ago.

Hello,

Ultrasound Whole abdomen can help in screening the current condition of your liver as you have mild discomfort in right side of abdomen.

Even it gives you a good clue that your fatty liver has reversible.

It should be done only for a precautionary measure.

Main good thing is that your blood work is fine.

 

I hope this helps.

Please rate me highly (Star 5 Great Service), if you are satisfied with our conversation.

If you have any further query then feel free to ask.

Bonus and positive feedback are highly appreciated.

Good Luck.

Thank you.

 

Customer: replied 1 year ago.


What could be the reason that the liver may give me discomfort? Inflammation? And if the ultrasound showed the fatty liver again, what could be done other than what I am doing? Last ultrasound showed no other abnormalities like cysts, tumors, scarring, etc.


 


Sorry for all the follow ups. i will additionally compensate you.

Expert:  Dr. Anil Kumar replied 1 year ago.

Hello,

Mild discomfort in right side of abdomen can be caused due to Liver inflammation,Renal calculi,Muscloskeletal pain,bloating.

There is no specific medication for treating Fatty liver.

Only line of treatment is treating the underlying cause(QUIT ALCOHOL,REDUCE WEIGHT,LIMIT FAT RICH DIET).

So having said this,chances of liver inflammation are less as your blood work is fine.

Most possible cause can be Muscloskeletal pain,bloating.

So you can try gentle massage with muscle relaxant ointment and warm compresses with a heating pad when you get discomfort.

Also hydrate yourself with plenty of fluids.

 

I hope this helps.

Please rate me highly (Star 5 Great Service), if you are satisfied with our conversation.

If you have any further query then feel free to ask.

Bonus and positive feedback are highly appreciated.

Good Luck.

Thank you.

 

 

Customer: replied 1 year ago.


Last reply: What is renal calculi?


 


Would inflammation of the liver cause my enzymes be higher than normal?


 


I believe that I had this discomfort prior to the diagnosis of fatty liver...so in all likelihood, my lower back problems could be the cause? I start physical therapy next week.


 


I am so sorry. This is consuming me. Can I wait until July when I see my dr to ask about ultrasound?

Expert:  Dr. Anil Kumar replied 1 year ago.

Hello,

Renal calculi are kidney stones.

 

Inflammation of the liver cause your enzymes be higher than normal.

 

Yes you can wait until July to ask your doctor for ultrasound.

Physical therapy can be helpful.

 

 

I hope this helps.

Please rate me highly (Star 5 Great Service), if you are satisfied with our conversation.

If you have any further query then feel free to ask.

Bonus and positive feedback are highly appreciated.

Good Luck.

Thank you.

 

 

 

Dr. Anil Kumar, General Physician
Category: Health
Satisfied Customers: 6679
Experience: M.D. with over 30 years of experience in practice.
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