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Suggest Treatment For Elevated Liver Enzymes

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Posted on Wed, 18 Feb 2015
Question: Hi I was in the ER Saturday with severe upper abdominal pain. Labs showed my ast elevated to 128 and my alt at 158. I had my gallbladder removed April 2013. The ER de suggested maybe a stone blockage and sent me for a ct scan m. However for some strange reason my kidneys and appendix were not even visible. I'm assuming it was a poor ct scan. I was sent home and told to have levels check again in 3 days. Sunday I began having diarreha. Yesterday I was having strange pains where my gallbladder was. I am not able to eat anything without it upsetting my stomach. I went for repeat labs yesterday and my ast went down to 43 which is still elevated, my Alt is even higher 161 m, and my alp (which was normal Saturday 111) is now high 170. I am so worried I can't sleep. I do not drink or do drugs. Could this really be a blockage like the ER dr thought at first??? Help I am worried.
I am concerned about my labs being elevated, along with this diarrhea and stomach pains. What could cause my alkp to rise so high so fast?
doctor
Answered by Dr. Dr. Muhammad Sareer Khalil (1 hour later)
Brief Answer:
ALP is not excessively out of range, re check in a months time

Detailed Answer:
Hello and Welcome

I appreciate your concern

The ALP is moderately elevated and may be physiological, e.g growth spurt. The ALT is more specific w.r.t the liver. Both AST and ALT can be elevated due to a number of reasons, including meds like statins, antibiotics, chemotherapy, aspirin.

Hepatitis, obstruction of biliary tract and cardiac pathology (in AST mainly). Its strange that the CT couldn't pick up the kidneys on the scan. I would advise you to get an Ultrasound of the abdomen and pelvis done to look for any biliary tract pathology or any sign of kidney stone disease. A urine R/E and stool for ova and parasite should also be done.

Meanwhile you should be on PPIs to empirically counter any GERD or Peptic ulcer disease. If there is evidence of infectious diarrhea , i.e blood or wbcs in stool along with high grade fever, then antibiotics can also be initiated. Hepatitis profile along with Bilirubin, albumin and pro thrombin levels should also be done to ensure that the synthetic function of the liver is intact.

Let me know if you have any query

wishing you best of health

Dr. M.S. Khalil
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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Answered by
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Dr. Dr. Muhammad Sareer Khalil

General & Family Physician

Practicing since :2012

Answered : 2906 Questions

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Suggest Treatment For Elevated Liver Enzymes

Brief Answer: ALP is not excessively out of range, re check in a months time Detailed Answer: Hello and Welcome I appreciate your concern The ALP is moderately elevated and may be physiological, e.g growth spurt. The ALT is more specific w.r.t the liver. Both AST and ALT can be elevated due to a number of reasons, including meds like statins, antibiotics, chemotherapy, aspirin. Hepatitis, obstruction of biliary tract and cardiac pathology (in AST mainly). Its strange that the CT couldn't pick up the kidneys on the scan. I would advise you to get an Ultrasound of the abdomen and pelvis done to look for any biliary tract pathology or any sign of kidney stone disease. A urine R/E and stool for ova and parasite should also be done. Meanwhile you should be on PPIs to empirically counter any GERD or Peptic ulcer disease. If there is evidence of infectious diarrhea , i.e blood or wbcs in stool along with high grade fever, then antibiotics can also be initiated. Hepatitis profile along with Bilirubin, albumin and pro thrombin levels should also be done to ensure that the synthetic function of the liver is intact. Let me know if you have any query wishing you best of health Dr. M.S. Khalil