Q: My 48 years old wife suffered from ascites last year along with anaemia and weakness. She was then admitted in the hospital. After giving some medication and blood transfusion, she recovered. But during our recent consultation with the doctor, her ESR level was found to be increased to 104 mm/hr. However, no signs of ascites were found. The ultrasound revealed impressions of mild splenomegaly and cholelithiasis. What is splenomegaly and cholelithiasis? What are their reasons of occurrence? Please advise. My wife was given Akurit-4 for the first 2 months and later she was given Akurit-3 for another 2 months. Preceedingly she was given rifampicin and ethambutol and along with these medicines she takes B-complex and iron tablets.

A:I note that your wife had ascites a year ago and I presume that it was due to tuberculosis as the treatment she received was for the condition. Cholelithiasis means gallstones and for this you need her to consult a surgeon for necessary surgery, especially when there is more than one gallstone. Splenomegaly means enlargement of the spleen, which needs investigations as it is usually associated with certain forms of anaemia and I note that she has received blood transfusion for the same. For this you need her to consult a haematologist for investigations and appropriate treatment.