Brief Answer: List of causes listed; chronic liver disease Detailed Answer: Hello sir and welcome. Thank you for writing to us. The most likely cause of altered liver function and abnormal bleeding are chronic liver diseases. I shall list out the most likely conditions that could have a presentation similar to yours: -Hepatitis B or C infections; or autoimmune hepatitis -Chronic alcohol abuse -A few medications -Bile duct disorders -Hereditary diseases -Other less common liver conditions I would advise an ultrasound of the abdomen which would help in better visualization of the liver, and once a liver abnormality is detected I would advise a more invasive investigations like a retrograde cholangiopancreatography (ERCP) which will help visualize the liver and the biliary tract. All your symptoms are related to this condition and the fact that you have been losing blood. Please also check on your hemoglobin levels, as the loss of blood could have resulted in anemia, which could be causing the tiredness and giddiness. I hope you find my response both helpful and informative sir. Please feel free to write back to me for any further clarifications, I would be more than happy to help you. Best wishes.

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