
What Do My Lab Test Reports Indicate?

Questions so that I can help:
Detailed Answer:
Hello and welcome,
Before I get into the possibilities, I have a few questions for you so that I can be more specific:
1. Can you either upload your labs here (there is a "button" on your screen that says "upload reports") or write the results for each (along with the reference range the lab used if possible)?
2. How long have you been having the left upper abdominal pain?
3. How severe is it?
4. How frequent?
5. Any correlation of pain with eating?
6. Were liver function test done?
7. Do you drink alcohol, and if so, would you be willing to say the amount?
8. Are your stools "normal"?
9. Do you take any medications for any ongoing problems, such as for cholesterol?
10. Any pain in the right upper quadrant of your abdomen?
11. Can you please provide your height and weight - thanks!
The more thoroughly you can answer these questions, the better I can respond - thanks!


1. bilirubin range 0.10-1.20 mg/dl; my result was 1.38
2. At least couple weeks
3. Dull pain to sharp. Woke me up a couple weeks ago. I thought it was a muscle spasm, from hiking the day before.
4. Pain is constant. Mostly dull.
5.no
6. I can't figure out how to upload the report.Is that serology? That shows non-reactive result for anti-HPV. Albumin and globulin both were in the normal range.
7. Yes. 1-2 drinks most days.
8. I think so
9. No. Only take over the counter for sleep, low dose aspirin and vitamin supplements.
10 No
11. 6'1, 200lbs

Information
Detailed Answer:
Thanks - this information is helpful.
The amount that your bilirubin is elevated is mild, but given that you are also having the left upper quadrant pain with radiation, I think it needs to be followed up.
Left upper quadrant pain that radiates to the back can be from gastritis (inflammation of the stomach lining which is usually treated with an H2 blocker like Zantac, or with a proton pump inhibitor) but it can also be caused by inflammation of the pancreas. In addition, sometimes inflammation or partial blockages going on on the right side (liver, gall bladder) can cause left sided pain if there is some blockage of the duct that drains out of it, such as with gall stones. The opposite is true too, on the left side,inflammation of the pancreas or it's ducts that lead into the small intestine can cause some inflammation of the liver (and therefore increased bilirubin levels) because they share the duct that drains into the small intestines.
So what to do:
Go in to see your doctor or go in to an urgent care clinic if you can't get in to see your own doctor promptly.
You should have a full liver panel done. These are tests of enzymes the liver makes such as AST and ALT. Elevations in these indicate the liver is having some inflammation.
Get another bilirubin test done: this one should include both Total, Direct, and Indirect bilirubin levels.
(While you are there, ask the doctor to consider ordering an A1C test to see how your sugars have been averaging over the past 2-3 months, since you mentioned that your blood sugar level was high when you were screened.)
Depending on these results, your doctor may want to get an abdominal ultrasound. This looks at the liver, gall bladder, and pancreas. It can show if there are stones or inflammation or fatty changes.
Until this is all sorted out, no alcohol. Not even 1 drink. Because it is irritating to the stomach lining, and can cause inflammation to the liver and pancreas.
And if possible, can you go without the aspirin until this is sorted out? Because aspirin is directly irritating to the stomach lining.
I also recommend going to the drug store and getting over the counter Zantac 150 mg and taking it either twice a day of 300mg at bedtime. We don't know for sure that the pain in the left upper quadrant is from your stomach, but Zantac is a safe medication with few risks, and it may help with the pain if the pain is caused by the stomach because it will help allow the stomach lining to heal. It is unlikely to help if the pain is from the pancreas though. Take the Zantac for a week to see if it makes any difference. If it helps, continue for 1 month or per the recommendation of your doctor who will be able to soon find out the source of pain via the tests I mentioned.
I hope this information helps. I would't worry about anything too serious at this point, but do follow up with a doctor for the tests. Please let me know if I can provide further information.


Sounds good.
Detailed Answer:
I'm glad you will be seeing your doctor Friday. But if the pain gets worse, don't wait - go in to urgent care and they can get some of these tests started. Or if the pain is quite bad, then the ER instead.
I would be happy to answer any questions about this in the future.
Best regards,
Bonnie Berger-Durnbaugh, MD


Ok
Detailed Answer:
Sounds reasonable!

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