Dietary Guidelines for Managing Elevated Ammonia Levels in Liver Cirrhosis
Diet for Elevated Ammonia Levels Hello, doctor. My father is 56 years old and currently has grade C liver cirrhosis. His last blood test showed an ammonia level of 277, which is slightly elevated. He is alert, but I'm unsure about his diet. I'm worried that if he consum...
Dr. Cai Anshun Reply:
Hello: For patients with a tendency towards hepatic encephalopathy, it is advisable to provide 40 to 50 grams of protein daily (0.5 to 0.7 grams per kilogram of body weight). Once symptoms of hepatic encephalopathy arise, the protein intake should be immediately reduced to 25 to ...[Read More] Dietary Guidelines for Managing Elevated Ammonia Levels in Liver Cirrhosis
Should You Remove a Pancreatic Tumor? Understanding MRI Reports
Is surgical resection necessary for this tumor based on the pancreatic MRI report? Recently, a family member experienced severe abdominal pain (radiating to the back) and underwent an MRI examination, which revealed a tumor in the pancreas. The hospital that performed the MRI sug...
Dr. Chen Qifeng Reply:
It is advisable not to rely solely on the report's content; it is important to consult with a clinical physician for their opinion.[Read More] Should You Remove a Pancreatic Tumor? Understanding MRI Reports
Understanding Liver Issues: Insights from Ultrasound Reports and Symptoms
Liver issues? Hello Dr. Tsai! I would like your help reviewing my abdominal ultrasound reports from two different hospitals, thank you. **First Report:** - Spleen Index: 7.18 × 3.75 cm - CBD: 0.63 cm - Portal vein: 1.05 cm - Normal liver size, bright and heterogeneous parenchyma...
Dr. Cai Anshun Reply:
Hello: 1. According to the report you provided, the liver appears to be only fibrotic, with no signs of cirrhosis. Additionally, your platelet count is 241,000; individuals with cirrhosis typically have platelet counts below the normal range (169,000). 2. Chronic anemia can i...[Read More] Understanding Liver Issues: Insights from Ultrasound Reports and Symptoms
Could My Symptoms Indicate a Possible Pancreatic Tumor?
Is there a possibility of pancreatic tumor? Hello Doctor, I am 29 years old and here is my situation. Recently, on a night in November, I felt a dull ache and bloating in my right abdomen. For several days, I have had a slight sensation in my right upper abdomen, but it is not as...
Dr. Chen Qifeng Reply:
Your symptoms can be explained by gallstones. If the doctor has diagnosed you with no pancreatic tumor and multiple tests have shown the same results, there is no need to worry too much.[Read More] Could My Symptoms Indicate a Possible Pancreatic Tumor?
Understanding Gallbladder Polyps and Liver Hemangiomas: Monitoring Guidelines
Gallbladder polyps and hepatic hemangiomas? Hello, doctor. During my employee health check last year, I was found to have a gallbladder polyp measuring up to 0.33 cm and a hepatic hemangioma (size not specified). In this year's check-up (at a different hospital), the gallbla...
Dr. Chen Shidian Reply:
Hello, Miss. It should be within the margin of error, so there is no need to worry. The two values are unlikely to increase significantly; annual follow-up is sufficient. Changhua Hospital cares about your health. Chen Shidian.[Read More] Understanding Gallbladder Polyps and Liver Hemangiomas: Monitoring Guidelines
Early Stage Liver Cancer: Treatment Options and Considerations
Early-stage liver cancer treatment? Hello Dr. Chen, my father is a carrier of hepatitis B and has gallstones. Last month, an MRI at Asia University Hospital revealed a 1 cm tumor in the hepatic vein. Due to its proximity to blood vessels, it is not suitable for radiofrequency abl...
Dr. Chen Shidian Reply:
Hello, Miss. You can visit Dr. Huang Kai-Wen at National Taiwan University Hospital for a discussion on new treatment options (out-of-pocket). Changhua Hospital cares about your health. Chen Shidian.[Read More] Early Stage Liver Cancer: Treatment Options and Considerations
Understanding Abnormal Liver Function Tests: Causes and Concerns
Abnormal liver function test results? Hello Doctor, I have a few questions. I have not been very healthy regarding my gastrointestinal system since middle school, experiencing recurrent issues such as duodenal ulcers, gastric ulcers, and gastroesophageal reflux disease. I usual...
Dr. Cai Anshun Reply:
Hello: 1. If the values are greater than normal, it can be classified as acute hepatitis. However, if it is accompanied by jaundice and coagulation dysfunction, it indicates hepatic decompensation, which poses a risk. 2. There are many causes of hepatitis; if you have not been ev...[Read More] Understanding Abnormal Liver Function Tests: Causes and Concerns
Understanding Gallstones: Symptoms, Risks, and Treatment Options
Gallbladder stone issues? I recently had an ultrasound of my gallbladder, which revealed a gallstone measuring 0.5cm x 0.6cm x 0.5cm. The report states: "The gallbladder is well distended. A focal echogenic non-mobile lesion measuring 0.5cm x 0.6cm x 0.5cm is seen adhering t...
Dr. Cai Anshun Reply:
Hello: The report describes a fixed lesion on the gallbladder wall (which does not move because of the stone; it rolls when changing positions), resembling a gallbladder polyp rather than a gallstone. The maximum diameter is currently about 0.6 cm, so there is no need for excessi...[Read More] Understanding Gallstones: Symptoms, Risks, and Treatment Options
Understanding Diaphragmatic Asymmetry: Causes and Concerns
Diaphragmatic asymmetry Hello doctor, a while ago I experienced difficulty breathing, so I visited a pulmonologist. After an X-ray, the doctor mentioned that my diaphragm is asymmetric. Could this possibly be congenital, or could there be other reasons? Thank you, doctor.
Dr. Chen Qifeng Reply:
Congenital conditions should be evaluated. It is recommended to perform an abdominal ultrasound to rule out hepatic lesions.[Read More] Understanding Diaphragmatic Asymmetry: Causes and Concerns
Understanding Post-Bowel Movement Itching: Causes and Solutions
Why is my stool like this? After I have a bowel movement, I feel a particularly itchy sensation around the anus after a while. This has been happening for several days; it only occurs after a bowel movement and not otherwise. What could be the reason for this?
Dr. Cai Anshun Reply:
Hello: It could be an internal hemorrhoid or an issue with the skin around the hepatic portal area. You can keep the area dry and ensure that your stools are not too hard. If there is no improvement, you may consult a colorectal specialist or a gastroenterologist. Changhua Hospit...[Read More] Understanding Post-Bowel Movement Itching: Causes and Solutions
Deciding on Embolization for Advanced Liver Cancer: Expert Insights
Is embolization necessary? My mother is 74 years old and has had liver cancer for several years. She has undergone embolization and radiofrequency ablation. Ten days ago, she was hospitalized due to early-stage hepatic encephalopathy, which has been treated and stabilized. A rece...
Dr. Chen Shidian Reply:
Hello, it is not advisable to proceed with embolization at this time. It is recommended to wait for about one month until improvement is observed before reconsidering. Please discuss individual circumstances further with your attending physician. Changhua Hospital cares about you...[Read More] Deciding on Embolization for Advanced Liver Cancer: Expert Insights
Understanding Right Upper Abdomen Pain: Causes and Insights
Right upper quadrant issues? Hello Dr. Tsai, In recent days, I have been experiencing intermittent sharp pain in my upper right abdomen near the last rib, which feels similar to nerve pain. The pain is horizontal and approximately ten centimeters in length. It diminishes or eve...
Dr. Cai Anshun Reply:
Hello: (1) If there are questions regarding the report, physicians from different specialties may not provide much explanation for parts they do not understand. It is advisable to consult the physician who originally arranged the examination or a specialist in that field. (2) The...[Read More] Understanding Right Upper Abdomen Pain: Causes and Insights
Understanding the Risks of Cancer Related to Jaundice Symptoms
Is the risk of cancer high? Hello, doctor. I researched some symptoms of jaundice in adults. In this stage, hepatitis is the primary cause of jaundice, especially chronic hepatitis B and C. Some patients may progress to cirrhosis or develop liver cancer, which can severely affect...
Dr. Cai Anshun Reply:
Hello: It is recommended to monitor the changes in the indices. If the jaundice is caused by diseases of the pancreas, bile ducts, or liver, the indices will gradually increase. At that time, a physician will evaluate what kind of examinations should be arranged. You should also ...[Read More] Understanding the Risks of Cancer Related to Jaundice Symptoms
Understanding the Growth of Liver Hemangiomas: What You Need to Know
Hepatic hemangiomas grow larger over time? Hello, Doctor: Our company conducts health check-ups every year. During the first year, an ultrasound examination revealed that I have a 5 cm hepatic hemangioma. The doctor referred me to the hospital for an MRI, which confirmed the diag...
Dr. Lin Minghui Reply:
Hemangiomas are benign tumors caused by vascular proliferation, with unknown origins. Some are congenital, while others may be related to hormones. Generally, hemangiomas are asymptomatic; however, if they are large (greater than 10 centimeters), they may present symptoms such as...[Read More] Understanding the Growth of Liver Hemangiomas: What You Need to Know
Do You Need Further Diagnosis for Growing Liver Hemangiomas?
If a hepatic hemangioma is found to be enlarging, is further diagnosis necessary? Hello, Doctor. Six years ago, I was diagnosed with a hepatic hemangioma measuring approximately 2 cm during an ultrasound examination. All other values were normal, and I do not have hepatitis. I ha...
Dr. Chen Qifeng Reply:
In general, the likelihood of hepatic hemangiomas enlarging is very rare. If a series of follow-ups shows that they are indeed growing, surgical intervention may be considered. Wishing you good health.[Read More] Do You Need Further Diagnosis for Growing Liver Hemangiomas?
Understanding Liver Cancer Treatment Options and Follow-Up Care
Treatment options for liver cancer? Dear Dr. Chen, My father underwent surgery for gastroesophageal junction cancer (stage III) in November 2015. After the surgery, he had a follow-up positron emission tomography (PET) scan to monitor his recovery, which revealed two liver tumor...
Dr. Chen Qifeng Reply:
If a series of follow-ups consistently shows a liver tumor that remains unchanged in size, it is likely benign. However, if it was not detected in previous examinations and is a recent finding, especially in the presence of hepatitis B or C, the likelihood of it being liver cance...[Read More] Understanding Liver Cancer Treatment Options and Follow-Up Care
Understanding Atypical Liver Hemangiomas: Are They Malignant?
Hepatic hemangioma Hello, doctor. About 4 to 5 years ago, during a health check-up, an ultrasound found a suspected hepatic hemangioma measuring 0.6 mm. I have been monitored every three months to six months, and now it's once a year, with the size consistently at 0.6 mm. Al...
Dr. Chen Shidian Reply:
Hello, Miss: Based on what has been described, it appears to be a benign small tumor with no likelihood of malignancy, so there is no need to worry at this time. For further details, it is necessary to discuss and evaluate the actual imaging data with your gastroenterologist. Cha...[Read More] Understanding Atypical Liver Hemangiomas: Are They Malignant?
Understanding Liver Hemangiomas: Are They Serious?
What is a liver hemangioma and is it serious? I had two tumors in my liver, measuring 1 cm and 2 cm, respectively, confirmed by a CT scan as hepatic hemangiomas. My attending physician was very busy, so I couldn't quickly ascertain the severity of the condition, which caused...
Dr. Chen Shidian Reply:
Dear Mrs. Huang, This is a common benign congenital liver tumor, and the principle is to follow up once a year. Most of the time, it does not change. Changhua Hospital cares about your health. Sincerely, Chen Shih-Tien[Read More] Understanding Liver Hemangiomas: Are They Serious?
Understanding Liver Hemangiomas: When to Consider Surgery
Hepatic hemangioma Hello, Doctor! In recent months, I have been diagnosed with a hepatic hemangioma. The examination process during this time is as follows: 1. Alpha-fetoprotein (AFP) levels: In 2014, the AFP level was over 11; in August 2015, it was over 12; and in November 2015...
Dr. Chen Shidian Reply:
Hello, Miss: There is likely no need for concern; the fetal protein levels have only slightly increased, and their current significance may be minimal. There may be slight discrepancies in the ultrasound measurements. Please continue to monitor patiently. Changhua Hospital cares ...[Read More] Understanding Liver Hemangiomas: When to Consider Surgery
Understanding Right Abdominal Bloating: Causes and Next Steps
Right-sided abdominal distension, dry mouth, and halitosis? Hello Doctor, I am 19 years old and have been experiencing bloating on the right side of my abdomen for the past three weeks. I have visited both a small clinic and a large hospital, where I underwent an ultrasound. They...
Dr. Cai Anshun Reply:
Hello: The upper right abdomen approximately contains the liver, gallbladder, pylorus of the stomach, duodenum, kidneys, and the hepatic flexure of the colon. If the ultrasound examination shows no issues, it can rule out kidney stones, gallstones, and liver masses (but cannot ex...[Read More] Understanding Right Abdominal Bloating: Causes and Next Steps