Managing Liver Cirrhosis and Alcohol Withdrawal in Older Adults
Cirrhosis and Alcohol Abstinence My father is 62 years old and has been drinking alcohol daily for the past 5 to 6 years. When he doesn't drink or consumes a smaller amount, he experiences severe tremors. He has undergone MRI, EEG, and blood tests, and the doctor has informe...
Dr. Chen Shidian Reply:
Miffy: In cases of cirrhosis combined with alcohol withdrawal, during the acute phase (within 2-3 days of withdrawal), sedatives and vitamin therapy are required, followed by a gradual tapering of medication. Long-term, psychiatric support for alcohol cessation (group therapy) is...[Read More] Managing Liver Cirrhosis and Alcohol Withdrawal in Older Adults
Understanding Upper Abdominal Discomfort: Possible Causes and Solutions
Unusual discomfort in the upper abdomen? I have a bulge below my xiphoid process extending to the right rib cage, which becomes more noticeable after eating. I usually don't pay attention to it, but now there's a slight, dull pain. Could you please help me with this? Th...
Dr. Lin Minghui Reply:
Hello, upper abdominal pain after eating, accompanied by a feeling of fullness, may indicate issues with the stomach or duodenum, which could be functional or organic (such as gastritis or peptic ulcers). Problems with the liver, gallbladder, or pancreas can also cause pain. It i...[Read More] Understanding Upper Abdominal Discomfort: Possible Causes and Solutions
Navigating Treatment Options for Elderly Patients with Liver Cancer
Liver cancer Hello: My father has been diagnosed with liver cancer, with a tumor approximately 11 centimeters in size. He is 76 years old. One hospital suggested that due to his advanced age, they do not recommend any treatment. Another hospital proposed chemotherapy and radiatio...
Dr. Chen Shidian Reply:
Hello, Miss: If you are too weak, special treatments are not recommended (such as photon therapy, which is a form of radiation therapy). Oral anticancer medications (not chemotherapy!) can extend life by a few months, but they are expensive and have many side effects. You may try...[Read More] Navigating Treatment Options for Elderly Patients with Liver Cancer
Understanding Elevated Blood Ammonia Levels: Causes, Symptoms, and Testing
Blood ammonia I have alcoholic hepatitis, coronary artery disease, a minor stroke, and gallstones. Recently, I went to the emergency room due to abdominal bloating, chest pain, and difficulty breathing. Blood tests showed my serum ammonia level was 130. The doctor informed me tha...
Dr. Lin Minghui Reply:
Hello, elevated ammonia levels are toxic to the brain. Normally, ammonia is produced from protein metabolism. However, the human body has a urea cycle system to eliminate ammonia. In children with congenital metabolic disorders, this can lead to hyperammonemia, which may present ...[Read More] Understanding Elevated Blood Ammonia Levels: Causes, Symptoms, and Testing
Essential Monitoring Tests for Chronic Hepatitis B and Fatty Liver
Regular follow-up items for hepatitis B? Hello, I previously went for a hepatitis B check-up, but the report only listed two items: liver enzymes and alpha-fetoprotein. Since I am a carrier of hepatitis B and also have fatty liver, are these two tests sufficient? Should I also ch...
Dr. Chen Shidian Reply:
Hello, sir: Liver enzymes refer to GOT/GPT. For fatty liver, it is important to monitor blood lipids, and for hepatitis B, regular ultrasound examinations are necessary. Changhua Hospital cares about your health. Chen Shidian.[Read More] Essential Monitoring Tests for Chronic Hepatitis B and Fatty Liver
Understanding Drug Resistance in Hepatitis B Treatment: A Case Study
Antimicrobial resistance My son is 24 years old and is studying for his master's degree in America. He is HBe positive and HBe negative. 1. He has been on lamivudine since January 2008. 2. On December 29, 2008, his lab results showed AST 31, ALT 46, and HBV-DNA approximate...
Dr. Lin Minghui Reply:
Hello, for patients with chronic hepatitis B who have been on Lamivudine for one year and show an increase in viral load, there is a possibility of developing Lamivudine resistance. When Lamivudine resistance occurs, the current recommendation is to use Lamivudine in combination ...[Read More] Understanding Drug Resistance in Hepatitis B Treatment: A Case Study
Understanding HBV Resistance: A Case Study in Treatment Challenges
HBV-DNA My son is 24 years old and studying for his master's degree in America. He is HBe positive and has a negative HBe antigen. He has been on lamivudine since January 2008. On December 29, 2008, his lab results showed AST 31, ALT 46, and HBV-DNA approximately 500 million...
Dr. Chen Shidian Reply:
Hello Mr. John: You may first check for HBV drug resistance (out-of-pocket, available only at a few medical centers). If drug resistance is present, you may consider switching medications (though there is a risk of developing resistance again) or, depending on the situation, swit...[Read More] Understanding HBV Resistance: A Case Study in Treatment Challenges
Understanding Hepatitis C: Diagnosis, Treatment, and Transmission Risks
Hepatitis C Your girlfriend recently tested positive for Hepatitis C. Here are the answers to your questions: 1. **Next Steps for Testing and Treatment**: Your girlfriend should consult a hepatologist or a specialist in infectious diseases for further evaluation. The next steps ...
Dr. Chen Shidian Reply:
Dear Mr. A-Wei, I recommend checking the detailed information on the "Liver Disease Prevention and Treatment Academic Foundation" at National Taiwan University. Generally, active treatment is recommended when liver function is consistently above 80 (according to health...[Read More] Understanding Hepatitis C: Diagnosis, Treatment, and Transmission Risks
Understanding Right-Sided Back Pain: Causes, Diagnosis, and Treatment Options
Back pain Hello Doctor: I have been experiencing a dull pain near the right side of my back close to the waist, around the rib area, for the past five days. I am unsure what organ might be affected. It feels worse when I bend over, and I often wake up at night due to discomfort. ...
Dr. Chen Shidian Reply:
Hello Miss Nanxi: It is likely a neuromuscular issue. You may try applying a hot compress; if there is no improvement, please seek a medical examination from an internist. Changhua Hospital cares about your health. Chen Shidian[Read More] Understanding Right-Sided Back Pain: Causes, Diagnosis, and Treatment Options
Understanding Liver and Gastrointestinal Issues: When to Seek Further Testing
Regarding the liver and stomach? Hello, Gastroenterologist: A few days ago, I started feeling discomfort in my stomach, but I did not seek medical attention. One night, I suddenly experienced severe stomach pain that was unbearable, so I immediately went to the emergency room. I ...
Dr. Lin Minghui Reply:
Hello, 1. Based on your symptoms and test results, it appears to be acute hepatitis. The causes of acute hepatitis can be categorized into viral hepatitis (including hepatitis A, B, C, D, E, and other viruses such as EBV, CMV, HSV, etc.) and non-viral hepatitis, which includes ...[Read More] Understanding Liver and Gastrointestinal Issues: When to Seek Further Testing
Should You See a Doctor for Liver and Kidney Scan Results?
Do I need to see a doctor? The CT scan report of your father indicates: Apical fibrosis in both lungs; otherwise, the remaining lung is clear. There are left renal stones, a calcified spot in the liver, calcification of the coronary arteries, and a small cyst on the spleen. Shoul...
Dr. Chen Qifeng Reply:
Hello, Lungs: There may be fibrosis due to pneumonia, often a result of scarring from old pulmonary tuberculosis. Kidneys: Right kidney stone; if symptomatic, seek care from a urologist. Liver: Calcifications may also indicate intrahepatic stones; if asymptomatic, no treatm...[Read More] Should You See a Doctor for Liver and Kidney Scan Results?
Key Considerations for Liver Transplant After Hepatectomy
Questions about liver transplantation? Hello Dr. Chen: My father just had a liver resection surgery three months ago, where two tumors were removed—one benign measuring 0.5 cm and one malignant measuring 2 cm (with comprehensive examinations showing no metastasis). The doctor sai...
Dr. Chen Shidian Reply:
Hello, Miss: The issues regarding liver transplantation are too specialized and complex. Please consult with the transplant team at the medical center (remember to bring your complete medical records from the original hospital). Changhua Hospital cares about your health. Chen Shi...[Read More] Key Considerations for Liver Transplant After Hepatectomy
Understanding Liver Shadows: Are They Always a Cause for Concern?
There is a shadow in the liver? I would like to ask about my sister-in-law (27 years old). She recently had a health check-up at a medical center, and an ultrasound revealed a shadow approximately 2 cm in size. However, she does not have hepatitis B or C, and her liver function i...
Dr. Chen Shidian Reply:
Dear Miss Xiao Qi, Most liver cancers are caused by hepatitis B or C. Ultrasound can provide an initial differentiation, but regular monitoring of changes is still necessary. Changhua Hospital cares about your health. Sincerely, Chen Shidian[Read More] Understanding Liver Shadows: Are They Always a Cause for Concern?
Understanding Hepatitis B: Key Questions on Viral Load and Treatment Options
Hepatitis B issues Hello Dr. Lin: I am a carrier of hepatitis B and have regular check-ups every year. Earlier this year, I underwent tests, and the results showed that both GOT and GPT levels were normal, AFP was 2.7, e-antigen was negative, e-antibody was positive, and the abdo...
Dr. Lin Minghui Reply:
Hello, 1. The e antigen may turn negative again, but the chances are low. Those who have spontaneously cleared the e antigen are less likely to experience this. However, individuals who have received antiviral medication may have a chance of turning e antigen negative, although...[Read More] Understanding Hepatitis B: Key Questions on Viral Load and Treatment Options
Understanding Body Heat: When to Seek Gastroenterology Care
The body is prone to overheating? Hello, doctor. My body tends to feel warm easily, especially between 9:00 PM and midnight. I often need to find something to press against my palms and soles to cool down. I'm unsure which specialty I should consult for this condition. Durin...
Dr. Chen Qifeng Reply:
Hello, 1. Your fever seems to be related to your constitution; do you have an issue with being overweight? 2. Consumption of salty and sweet foods is unrelated to the spleen and does not correlate with fever. 3. You may consider paying for a comprehensive health check-up, which w...[Read More] Understanding Body Heat: When to Seek Gastroenterology Care
Understanding Abdominal Pain: Normal Endoscopy Results and Hidden Causes
Why are the results of the gastroscopy and colonoscopy normal, yet the cause of my abdominal pain cannot be identified? Dr. Chen: After undergoing gastroscopy and colonoscopy, the doctor diagnosed me with Helicobacter pylori and wrote in English—peptic ulcer. Therefore, I am unsu...
Dr. Chen Qifeng Reply:
Hello, based on the symptoms, it may just be functional issues such as bloating or indigestion. In theory, if there is a peptic ulcer, it should be treated; however, even if the coccyx is fractured, it should not penetrate the gastrointestinal tract. Having a family history of ca...[Read More] Understanding Abdominal Pain: Normal Endoscopy Results and Hidden Causes
Understanding Elevated AFP Levels: Next Steps and Treatment Options
Elevated AFP (Alpha-fetoprotein) Hello Dr. Lin, I would like to ask about my recent health check-up at work where I found that my AFP level is 97.75. I then went to the hospital for further examination, where they checked my GOT, GPT, and performed an ultrasound, as well as teste...
Dr. Lin Minghui Reply:
Hello, the high likelihood conditions associated with AFP include hepatitis, cirrhosis, liver cancer, pregnancy, and other less common cancers related to the embryo. For hepatitis, it is important to identify the cause, such as viral hepatitis, alcohol consumption, medications, a...[Read More] Understanding Elevated AFP Levels: Next Steps and Treatment Options
Understanding Dry Mouth and Sore Throat: Is Your Liver to Blame?
Liver Recently, I've been experiencing dry mouth and sores in my mouth, which are quite severe! My throat also hurts! Could this be related to my lifestyle, or is it an issue with my liver?
Dr. Lin Minghui Reply:
Hello, symptoms such as dry mouth, mouth sores, and sore throat can have various causes, including colds, fatigue, nutritional imbalances, and vitamin deficiencies. If you are concerned about liver issues, you can have a blood test done. Wishing you good health. Sincerely, Dr. Li...[Read More] Understanding Dry Mouth and Sore Throat: Is Your Liver to Blame?
Understanding HBV Viral Load: Key Questions for Chronic Hepatitis B Patients
Inquiry about Hepatitis B virus load? Hello Dr. Chen: I am a carrier of hepatitis B and have regular follow-ups every year. In February of this year, I underwent testing, and my results were as follows: GOT was 22, GPT was 19, alpha-fetoprotein was 2.21, e-antigen was negative, e...
Dr. Chen Shidian Reply:
Hello Mr. Wei: 1. It's not significant. Therefore, liver function is normal, and monitoring is sufficient. 2. Very few cases will revert. 3. Testing is only necessary when liver function is abnormal. 4. There should be no impact. Changhua Hospital cares about your health, Ch...[Read More] Understanding HBV Viral Load: Key Questions for Chronic Hepatitis B Patients
Understanding Abdominal Ultrasound Abnormalities: What to Do Next?
Abdominal ultrasound abnormalities? Hello~~~ Because my company has scheduled an annual health check, my liver function and Helicobacter pylori test results are normal. However, the hospital informed me that there are abnormalities in my abdominal ultrasound, and I have recently ...
Dr. Chen Shidian Reply:
Dear Miss Pi: If the liver ultrasound shows only "mild hepatic parenchymal changes" and liver function is normal without hepatitis B or C, there are generally no significant issues. However, it is still advisable to consult a hepatobiliary and gastroenterology specialis...[Read More] Understanding Abdominal Ultrasound Abnormalities: What to Do Next?