Your Digestive Issues: Gallbladder, Liver, and Stomach Concerns

I don't know what disease it is?

Hello Doctor,
I have been troubled by a persistent issue for a long time, and I kindly ask for your guidance.
About two years ago, I started experiencing stomach pain and have been receiving treatment at a clinic, with symptoms fluctuating between improvement and exacerbation.
It wasn't until mid-August of this year that I underwent an endoscopy and abdominal ultrasound at the hospital.
The results indicated mild gastritis, gallbladder polyps, and some coarse liver texture, but overall, the liver was deemed okay.
The examining physician advised that the gallbladder polyps should not be addressed at this time, but I need to have abdominal ultrasounds every six months for monitoring.
For the gastritis, I was prescribed two medications: Swei TAB (two tablets three times a day) and Mepenzolate (one tablet three times a day).
I have been adhering to the prescribed regimen, but my symptoms have not fully improved and continue to fluctuate.
Recently, I have been experiencing frequent acid reflux accompanied by a bitter taste, diarrhea, and abdominal bloating.
My weight has also decreased significantly (from approximately 70 kg to 58 kg, with a height of 174 cm).
Additionally, I am a carrier of hepatitis B, but my liver enzyme levels (AST and ALT) have remained normal.
I would like to ask the following questions:
1.
Is the acid reflux accompanied by a bitter taste indicative of bile reflux?
2.
What further tests should I undergo to accurately diagnose the conditions affecting my liver, gallbladder, and digestive system?
3.
Is it possible that my issues are related to hepatitis B, or could there be other concerns, such as tumors?
I sincerely apologize for adding to your workload during your busy schedule, and I appreciate your understanding.
Thank you once again.
I wish you good health and all the best.

Bu zhi suo cuo, 40~49 year old female. Ask Date: 2005/10/16

Dr. Xu Jinchuan reply Gastroenterology and Hepatology

Hello! 1.
Gastroesophageal reflux occurs when the lower esophageal sphincter is too relaxed, allowing stomach acid to flow back up into the esophagus.
There are many factors that can trigger this symptom, including high stress, obesity, and certain medications.
A gastroscopy can provide more detailed information.
2.
Based on the current examination report, your discomfort symptoms are not related to hepatitis B, and gallbladder polyps would not cause these symptoms.
It is advisable to consult with your physician, and if necessary, consider undergoing a gastroscopy.

Reply Date: 2005/10/16

More Info

Hello! Thank you for reaching out with your health concerns. It sounds like you have been dealing with a complex set of digestive issues, and I appreciate the opportunity to provide some insights based on the information you've shared.

1. Bile Reflux and Symptoms: Your question about whether the bitter taste and acid reflux could be due to bile reflux is quite valid. Bile reflux occurs when bile, a digestive fluid produced by the liver, backs up into the stomach and esophagus. This can lead to symptoms similar to acid reflux, including heartburn, a bitter taste in the mouth, and nausea. The presence of gallbladder polyps may also contribute to digestive issues, although they are often benign and monitored through regular ultrasound checks. It’s important to discuss these symptoms with your healthcare provider, as they may suggest further evaluation or treatment options.

2. Further Diagnostic Testing: Given your ongoing symptoms, it may be beneficial to consider additional diagnostic tests. An upper gastrointestinal (GI) series or a 24-hour pH monitoring test can help assess the extent of acid and bile reflux. Additionally, an endoscopic ultrasound (EUS) could provide a more detailed view of the gallbladder and surrounding structures, helping to rule out any complications or other conditions that may be contributing to your symptoms. If your symptoms persist, a referral to a gastroenterologist for a comprehensive evaluation might be warranted.

3. Potential Impact of Chronic Hepatitis B: As a chronic Hepatitis B carrier, it’s understandable to be concerned about the potential impact on your liver and digestive health. While your liver function tests (GOT and GPT) are normal, chronic Hepatitis B can sometimes lead to liver inflammation or fibrosis over time, which may not always be reflected in routine blood tests. However, it is less common for Hepatitis B to directly cause gallbladder or stomach issues. It’s crucial to maintain regular follow-ups with your hepatologist to monitor your liver health, especially since you have a history of chronic infection.

4. Weight Loss and Nutritional Concerns: The significant weight loss you’ve experienced (from 70 kg to 58 kg) is concerning and should be addressed promptly. Unintentional weight loss can be a sign of underlying health issues, including malabsorption or chronic illness. It’s essential to evaluate your dietary intake and ensure you are receiving adequate nutrition. Consulting with a registered dietitian can help you develop a meal plan that meets your nutritional needs while considering your digestive issues.

5. Lifestyle Modifications: In addition to medical management, lifestyle changes can play a significant role in managing digestive symptoms. Eating smaller, more frequent meals, avoiding trigger foods (such as spicy or fatty foods), and maintaining an upright position after meals can help reduce reflux symptoms. Staying hydrated and incorporating gentle physical activity, as tolerated, can also support digestive health.

In conclusion, your symptoms warrant a thorough evaluation to determine the underlying causes and appropriate management strategies. Regular follow-ups with your healthcare provider, along with any recommended diagnostic tests, will be key in addressing your concerns. Please don’t hesitate to reach out for further assistance, and I wish you the best in your journey toward better health!

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