Question: 32 year old female, 120 pounds, 5 ft 3 in tall. No history of other diseases. Do not drink or smoke. I had my gallbladder removed approximately 2 months ago( I was also 6 weeks postpartum from second child born vaginally), found stones and chronic cholecystitis. LFTs were highly elevated when I was admitted. For the first two weeks after the surgery, had difficulty eating, nausea and some pain reminiscent of the gallbladder pain though not as severe. MRCP was normal and those symptoms have improved. LFTs have come down but AST and ALT are still slightly elevated. Not sure of the exact number but less than 2 times normal. CBC, celiac, hepatitis, anemia tests all normal. Also ruled out wilsons I believe. Currently experiencing moderate RUQ pain that is different from what I experienced with the gallbladder. Pain is more XXXXXXX tenderness and there is an area of tenderness when touched on my abdomen near the site of the gallbladder. This pain increases when the colon is full and gas feels like it gets trapped in the ascending colon for a period of time. No nausea, no fever, no vomiting. Alternate between normal bowel movements, a couple of days of constipation that ends with a day of normal bowel movement followed by diarrhea emptying everything out. GI doc suspects IBS and is more concerned about continuing LFT elevation. Surgeon suggests adhesions and seems totally unconcerned with liver numbers. Any other ideas or tests I should request?

I had an abdominal ultrasound when I was in the ER. Would you expect there to be some evidence of XXXXXXX there or do they need to be looking for it specifically? GI doc mentioned possibility of liver biopsy if elevations continue..would you? Would you recommend any other imaging or testing before invasive biopsy?