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What Causes Pain In Abdomen And Chest?
Question: Doctor I feel pain all around my abdormen and chest sumtime like burning sensation especially righr side. I am heb b possititive with e antingent negative and undetectable hbv dna as at last 2 month. Recently my abdorminal scan shows excess gas colitis. And once I mistakenly tok overdose lamivudine for atleast 3 month which my doctor suddenly gave just because am heb possitive wirhout any further tests.
Brief Answer:
Lamivudine is currently not needed.
Detailed Answer:
Hi Sir,
I have carefully read your query and understand your concern.
Not all cases of positive hepatitis B needs therapy with lamivudine.
You seem to carry very low risk of progression to chronic phase hepatitis or liver cirrhosis considering your very low viral replicative potential as evidenced by negative e antigen and undetectable viral DNA.
Colitis can be very well delineated on Colonoscopy or MRI abdomen.
These abdominal symptoms are more likely to be lamivudine induced as in your case in my opinion.
Treatment with Proton pump inhibitors like Esmoprazole or Pantoprazole for 2 weeks can effectively reduce your abdominal symptoms.
This should be coupled with antibiotics like Ofloxacin and Ornidazole to treat your colitis.
Consult your doctor with regard to this drug therapy.
Treatment with antivirals(like lamivudine) is indicated only when;
HBV DNA is above 2000IU/ml and serum ALT is greater than 30 IU/l for 3-6 months.
Currently you can be managed with diet modifications like:
1.Low sodium diet-1.5g/day
2.High protein diet-white meat protein like turkey,pork or fish.
3.Fluid restriction 1.5l/day in case of hyponatremia.
I hope this info is helpful to you.
Post your queries if any on http://bit.ly/drsureshheijebu.
Thank you
Lamivudine is currently not needed.
Detailed Answer:
Hi Sir,
I have carefully read your query and understand your concern.
Not all cases of positive hepatitis B needs therapy with lamivudine.
You seem to carry very low risk of progression to chronic phase hepatitis or liver cirrhosis considering your very low viral replicative potential as evidenced by negative e antigen and undetectable viral DNA.
Colitis can be very well delineated on Colonoscopy or MRI abdomen.
These abdominal symptoms are more likely to be lamivudine induced as in your case in my opinion.
Treatment with Proton pump inhibitors like Esmoprazole or Pantoprazole for 2 weeks can effectively reduce your abdominal symptoms.
This should be coupled with antibiotics like Ofloxacin and Ornidazole to treat your colitis.
Consult your doctor with regard to this drug therapy.
Treatment with antivirals(like lamivudine) is indicated only when;
HBV DNA is above 2000IU/ml and serum ALT is greater than 30 IU/l for 3-6 months.
Currently you can be managed with diet modifications like:
1.Low sodium diet-1.5g/day
2.High protein diet-white meat protein like turkey,pork or fish.
3.Fluid restriction 1.5l/day in case of hyponatremia.
I hope this info is helpful to you.
Post your queries if any on http://bit.ly/drsureshheijebu.
Thank you
Above answer was peer-reviewed by :
Dr. Shanthi.E
thank you for your professional response. Doctor i forgot to mention to you that my recent LFTs is ALT 77 and AST 54, but prior to my lamivudine overdose my LFTs is normal. hope the drugs you mention above is still safe for me? if yes what is the doses and should i combine them with livolin forte am currently taking? thank you.
Brief Answer:
Elevated ALT levels are not a contraindication.
Detailed Answer:
Hi Sir,
Good to have you back.
An elevated ALT of 77 iu/ml is not a contraindication for using proton pump inhibitors or the antibiotics i mentioned.
Yes you can definitely take them with Livolin forte.
The recommended dosage schedule for Esmoprazole is 20 mg once a day at 7 am before breakfast for 21days.
The recommended dosage schedule for Orni-O is 400 mg twice a day after a meal for 7-14 days.
Consult your treating doctor with regards to above.
I also strongly advice you to have a LIVER FUNCTION TESTS along with HBV DNA levels every 3 months and report them to your physician without fail.
I hope this info is helpful to you.
Thank you
Elevated ALT levels are not a contraindication.
Detailed Answer:
Hi Sir,
Good to have you back.
An elevated ALT of 77 iu/ml is not a contraindication for using proton pump inhibitors or the antibiotics i mentioned.
Yes you can definitely take them with Livolin forte.
The recommended dosage schedule for Esmoprazole is 20 mg once a day at 7 am before breakfast for 21days.
The recommended dosage schedule for Orni-O is 400 mg twice a day after a meal for 7-14 days.
Consult your treating doctor with regards to above.
I also strongly advice you to have a LIVER FUNCTION TESTS along with HBV DNA levels every 3 months and report them to your physician without fail.
I hope this info is helpful to you.
Thank you
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Above answer was peer-reviewed by :
Dr. Shanthi.E
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