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

### input:
Hi, My problem has been for 4 years now. It started with vomit in morning after getting up and pukish feeling lasting up for whole day. I diagnosed for the reasons and went through tests as guided by a physician (SGPT,SGOT count was reported high) last year(2012) but nothing particular came out and my doctor advised that this might be due to anxiety/depression. I was advised to take Trika Plus 0.5 by one of our family doctor for sometime, which i took for 6 months. Last year i referred to one of renowned psychiatrist in town as i was not getting permanent relief, he then advised me to take Clonotril 0.25 (Clonazepam) , Prothiaden and Rexipra 10mg (Escitalopram). I am on above said 3 drugs for last 1.5 years and during this time my pukish feeling was fine but i turned out too lazy ,sleepy, inactive and also sometimes suicidal thoughts crossed my mind. Now from 4 months back,I reduced the dose of medicines slowly, but now when i m further trying to reduce Rexipra i am unable to do that and also my symptoms are returning back i.e. pukish feeling round the clock and vomit sometimes. Now i feel that i am still there where i started and i am unable to decide that whether this problem is really due to anxiety/depression or do i have some kind of infection in my liver as recently( 7th Oct 2013 ) i went for a physical checkup and my report indicated : Lymphocytes 40.4 h (20 -40) Bun/Creatinine ratio 7.3 L (10 -24 ) Total protein 8.3 H (6 -8 ) SGOT (AST ) 46 H (0 -42) SGPT (ALT) 77 H ( 0 - 42) ANION GAP 16 H (5 - 15) CHOLESTEROL 211 H (LESS 200 ) LDL-CHOL (CACULATED ) 130 H ( LESS THAN 100MG/DL ) NON HD CHOL 150 H Please let me know whether i should keep my treatment running from psychological point of view or do i need to get my checkup through a gastroenterologist?

### output:

Dear Friend. Psychologically you can have vomiting but not deranged ALT ANF AST. Are you taking any Chat Doctor? Do you consume alcohol? I would like to know your age, total, direct bilirubin levels. Get your complete Liver function test, Bag, Anti HCV antibody, these both are to see for viral hepatitis. Get your USG Done to see for fatty liver. If you don't take alcohol, there is a condition called Non-Alcoholic Steaohepatitis NASH. We would like to rule out that. Review with us with the reports.