Q: I am a 38 years old man feeling strain below the right rib area like something swollen inside my abdomen for the last year. My height is 175 cm and weight is 75 kg. I have undergone scan and tests, the report states: haemoglobin: 11 gm, TLC: 9500, DLC: 68%, 30%, 1%, 1%, SGOT: 22.8 IU/L, triglyceride: 136 mg/dl, cholesterol: 199 mg/dl, creatinine: 1.22 mg/dl, glucose: 91 mg/dl, SGPT: 7 IU/l, HDC: 48 mg/dl, blood urea: 33 mg/dl, bilirubin total: 0.9 mg/dl, bilirubin direct: 0.2 mg/dl, ultrasound scan: all organs are normal; liver is normal in size. But there was diffuse increase in its echogenicity and few hypoechoic foci suggestive of focal sparing. Portal vein and biliary radicles were normal. Is there any thing serious? There is no pain in abdomen, except strain below the right rib and loose motion twice a day. Please advise.

A:Your ultrasound examination suggests that you may have a mild degree of fatty liver - this could be either due to alcohol (if you drink too much) or due to non alcoholic fatty liver disease (a common condition due to too much fat being deposited in the liver). Your lipid profile suggests that your cholesterol is very close to the upper limit of normal, and I do not know whether you have central adiposity or not (waist-to-hip ratio). Your weight suggests that you are not overweight or obese, a common cause of non alcoholic fatty liver disease, and you are also not diabetic (another common cause of fatty liver disease). This is not something, which is serious, and I would recommend that you decrease the amount of fatty food intake. Of course, ultrasound appearances are subjective and observer dependant, and so a second ultrasound is also recommended to confirm that the first report is accurate. An annual liver function test is all that is required for monitoring. You may also like to consult a gastroenterologist who can keep a watch over your liver functions. No medication is required at the present moment.