### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I had blood tests done last April which showed my cholestrol was too high.  I am not on any medication for this.  Last week my ankles swelled and were painful.  I went to the doctor and more blood tests were done.  These showed the elevated cholestral and also high liver enzymes, high enough I have to go back for more tests this week.  Any idea why the liver enzyme levels could go up since last April?  (Im 48 yr old, somewhat overweight female who does like a couple of beers every night.)

### output:

Hi, I am so sorry to hear about your condition. A raised enzyme level usually indicates damage to the liver cells. Fatty liver can be caused by excessive alcohol intake (Alcoholic SEATO hepatitis, ASH) or due to excessive fatty food intake and sedentary lifestyle (Non-alcoholic SEATO hepatitis, NASH). ASH is usually the beginning stages of alcohol induced liver damage and is completely reversible if the patient refrains from alcohol. NASH is being much more commonly diagnosed currently owing to poor dietary habits and sedentary lifestyles of people. High caloric intake, high fatty food intake and poor exercise regimens lead to deposition of fat goblets in the liver tissue leading to fatty liver (which shows up as increased echo texture on USG). This is also completely reversible in the initial stages if caloric intake is limited and exercise regimens are adhered to. If left unchecked, patients usually become obese, diabetic and in final stages may lead to cirrhosis of the liver which will necessitate a liver transplant. I would suggest a healthy diet and exercise regimen. Although there is no time limit on when to get a repeat scan, I would suggest one, once you have succeeded in losing some weight. Hope this helped, and please do not hesitate to contact me for further details - rxsuresh@gmail.com