diagnostic puzzle

CASE HISTORY – AGE 55 YEARS

In November 2002, Felt some gas discomfort on the right side under the ribs. This problem aggravated with the passage of time and gas pressure shifted to left side under the left ribs. This gas pressure also caused a big problem for my back, since I have bone degenerative disease for the last 10 years. The gas abundance under the right and left ribs is causing pain in my back while driving the car on a bumpy road and coming to sitting position from sleeping position. The gas and stool release does not cure the problem. At the start of the problem, the gas was so much excessive that it obscured my pancreas, as it was not visible in ultrasound. The gas pressure mostly remains under the right ribs, which sometimes under left ribs, sometimes lower right and left abdomin.

Surprisingly, an office boy, who serves me tea/coffee, had almost similar symptoms of gas and back pain. I also found from blood result that I am a recovered case of Hepatitis B (antibodies developed). It seems at the time of starting of this problem,
my immune system was also affected, as sugar was reported in my urine, which,
in a later test was negative.

When I don’t have gas pressure, I feel comfortable in my movement. When I have gas pressure, my condition becomes miserable with regard to movement in sitting, standing and sleeping and back pain.

Ultrasound result :
- The gall bladder contains multiple stone shadows; measuring in total 28 mm;
the largest measuring about 8 mm. No sludge or mass.
-Fatty lever (First grade). The liver measures 157 mm (upper 160 mm), it is normal in size and shape with slightly increased echogenicity in general (Grade-I Fatty Liver). The Outlines are smooth. No focal defect. No dilatation of the hepatobiliary ducts.
-Right Kidney 123 x 55 x 13 (Normal)
-Left Kidney 122 x 59 x 14 ( A 15 x 15 cortical cyst noted at the mid pole
No stone, hydronephrosis or mass
-Renal outlines are smooth. Corticomedullary differentiation is good
No supra-renal mass or cyst seen
-Urinary bladder is full. No stone, wall thickening or mass seen
- The prostate measures 25 x 20 with smooth outline
- No pelvic pathology seen
-No Pleural Effusion on either sides seen
-No abdominal mass, ascites or lymph nodes seen





Impression: Lipoma right hypochondrium
Fatty Liver (Grade-I)
Choleithiasis
Left renal cyst

X-ray Report: Lumbosacral Spine, LS. Spine & Pelvis

Lumbar lordotic curve well maintained
General decrease in bone density
Evidence of gross anterior degenerative osteophytosis
Vertebral bodies and disc space normal
Sacro-iliac joints normal
Hip joints show early degenerative oseo arthritic changes
No evidence to suggest Ankylosing Spondylitis

Note: I don’t feel back pain, when I don’t have abdominal gas
As reported above.

Blood result :

Hepatitis A : Negative
Hepatitis B: Recovered case showing antibodies
Hepatitis C: Negative
Alkaline phosphate:115 (NORMAL RANGE 106)
All other blood test within normal limits
Lever Enzymes: Sgot & Sgpt Normal
Glucose fasting : 112
Urea : Normal
ESR: Normal

Stool occult blood : Negative

Treatment:

A famous doctor in medicine told me that perhaps it is due fatty lever or IBS. Some doctors are of the opinion that perhaps it is caused by gall stones. I don’t have any heart burn or severe pain, which is due to gall stones.

My questions about diagnosis :

Is this gas pressure due to :
-Fatty lever
-IBS
-Gall stones
-After-effects of recovery from Hepatites B (why my office boy had also similar symptoms)

Presently, I am having gas/acidity cough. It seems something is in my throat which I have to swallow again and again.

I have gone through survey of using this oil forumula, and I am not impressed with results as there is a mixed feeling.

I want some experts to answer it.
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