Question: Hi I have had gastro problems for just over a year, started as left lower quadrant colicky pain. GP diagnosis of IBS. After a few months the pain was also felt in the upper right quadrant and though to right shoulder blade and mid back. I have had several blood tests, US, CT and MRI all of which suggest there are no problems with the liver. I have copies of the MRI. Today the pain in the liver area is unrelenting and my right knee has some minor swelling and pain. Pain also moves around joints. My GP ran a recent blood test for Lupus and RA and a liver panel. XXXXXXX was negative, liver ALT was 29 (17 - 63), GGT 21 (9 - 40), ALP 62 (32-91), total protein 64 (60-80), Albumin 42 (35-50), although this is reduced from my usual 50. Globulin was low at 22 (23-35), bilirubin was 13 (7-35) higher than my usual 8. RBC was also slightly low at 4.45 (4.5-5.5). Grateful for your thoughts whether or not I may have liver problems or indeed cirrhosis. Many thanks.

Thank you for your reply. Just a couple of follow up questions if I may. Is it possible to have cirrhosis and still have normal in range liver function tests and could cirrhosis be missed on CT or MRI. Or in other words, how easy is it to detect Cirrhosis with these methods?

I understand that Albumin is a good indicator of overall health, for the past 10 years or so my level has been steady at 50 iu/l. What is the significance of the level dropping by 8 to now read 42? Can the reading be different at different times of the day? Should I be concerned with the recent drop?