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Hi Doc I Need To Ask You A Question Please

Posted on Sat, 26 Oct 2019

Question: Hi Doc I need to ask you a question please for my peace of mind and your opinion so I don't need to go to the ER. Two weeks ago I was diagnosed with Gallstones. I am usually healthy 46 year old male. I take Ramipril 10mg for BP ( not high but borderline) and Nexium for Gerd. When I was diagnosed two weeks ago with Gallstones, my liver enzymes were elevated and e everything else was normal. I will send you a picture of all the results. Right now I am having Greenish stools and a little Diahreah/constipation and no stomach pain just not comfortable. I have a meeting with the doctor only ikn 2.5 weeks. Opinion? Thanks for your professional advice

Answered by Dr. Ramesh Kumar (1 hour later)

Brief Answer:
Normal.

Detailed Answer:
Hello and thank you for choosing HealthcareMagic for your query,
Have seen your details and I appreciate your concerns.
Biee which is stored in gall bladder is green in color. This bile is secreted when a person ingests food to break fat. If a person is anxious these bile pigments passes unbroken through the intestines giving stools green color. Anxiety increases the rate of persistalsis and hence bile is not broken down into stercobilinogen which gives brown color to stools. This is your case.
Gall bladder and liver form hepatobiliary system. If there is problem with one the other would be effected. Stones in gallbladder causes inflammation in hepatobiliary tract .This inflammation may cause mild damage to some cells of liver causing leakage if liver enzymes into blood.
Unless and until atleast two liver enzymes are three times elevated then the upper normal limit then we consider liver tests deranged.
For me it's normal..Just take an anti anxiety pill and green color would come back to brown.

All is good.
Nothing to worry,
Thanks.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Ramesh Kumar (3 hours later)

Hi Doctor XXXXXXX Thanks for the professional detailed answer. I don't think you saw the liver enzymes results. I just said that they were elevated I think around 156 if that means anything. I am just verifying as I am not suffering currently from Anxiety. I am just making sure. I can send you a full copy of all the blood tests if your interested. Just green and stomach discomfort. Maybe fatigue but no other symptoms. Thanks again and waiting to hear back from u Regards Aryeh

Answered by Dr. Ramesh Kumar (4 hours later)

Brief Answer:
Follow up.

Detailed Answer:
Hello again,
But I would like to bring to your kind notice that both the attachments attached with initial query were about gall stones.
No liver function tests values were uploaded so my answer was based on presuming that liver enzymes are not that high( other wise your primary would have cautioned you).
For a good professional advice it's always advisable to attach all details.
please feel free to upload images of all tests and at the end of follow up mention the number of images uploaded by you so I can cross check.
Thank you.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Ramesh Kumar (5 hours later)

Hi Doctor XXXXXXX Sorry for not uploading these from day one so here are all of the results from the blood work. Please let me know your opinion. Thanks again. Best regards Aryeh

Answered by Dr. Ramesh Kumar (1 hour later)

Brief Answer:
Follow up.

Detailed Answer:
Hi,
Again I am sorry but no reports related to liver functions can be seen.Only the two old reports regarding gallbladder are there.

Please upload and inform me.
Thanks

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Ramesh Kumar (4 hours later)

Hi again Doctor XXXXXXX I uploaded all the blood work yesterday and I guess it didn't go through so I am doing It again. Please let me know if you get it. Thanks again BR Aryeh

Answered by Dr. Ramesh Kumar (2 hours later)

Brief Answer:
Follow up.

Detailed Answer:
Hello again my dear,
Thanks for attaching reports,
Actually the problem with readings is that various laboratory follows various parameters and therefore the unit in which they are measuring enzymes plus the minimum and maximum range is always mentioned next to the test result report.
For example in Asia weight is measured in kilograms while in USA it's Lbs.
Secondly normal range of these enzymes at the lab you were tested is not mentioned and this range varies from machine to machine(different machines use different softwares).
So as they have rounded it definitely it's elevated but is it elevated three times the maximum value permissible..If not nothing to worry.
Call the lab and ask them the normal limit of these two enzymes and lipase.
As in my country the unit used is nanogram/litre and range of SGOT is 10-40...considering this 150-160 is 4 times the maximum permissible range..But as far as I think very likely they are using a different unit and range too is different .Time to talk to your lab technician.
Check list-
what unit are they using to measure.
what is the maximum and minimum range.
Once I got the answer you would get a fully professional advice.
Waiting for reply.
Thanks...
Hope you understood what I explained above.

Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Kampana