instruction: hello doctor I am 31 years old and weigh about 51 keg I am actually afraid to eat I took a liver function test my bilirubin total was 50 bilirubin direct 30 and bilirubin indirect 20 my triglycerides is 256 I feel nauseous all the time please suggest what to do I am taking pentate elpizyme syearup and liv 52
output: hi symptoms you have mentioned may occur due to liver disease stomach problem or esophagus related for differentiation in these entities we need detail discussion by message or by phone apart from the discussion your bilirubin is elevated but the liver function test is incomplete we need more information g got sept all proteins it apt and in I need answers for the following questions you are afraid of eating all the time but why it is due to difficulty in swallowing or it is due to burning epigastrium pain in abdomen or vomiting what is the onset of these symptoms do you take alcohol dou you have constipation jaundice family history of constipation or similar illness advice continue pentate pantoprazole and domperidone 40 my half an hour before meals once a day avoid fatty meals take syearup gelusil my with each feed intake take syearup eva multivitamin my two times a day avoid milk for sometime especially do not take in the morning hours do regular exercise get done let liver function test with the above mentioned tests if there is abnormality then we will plan further tests provide details about question marked symptoms report back with the report and detailed information or can discuss by phone