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Gastroenterology (Expert Forum)
Elevated Alkaline Phosphates, no gallstones, ???
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Elevated Alkaline Phosphates, no gallstones, ???
by Kellysbabies, Oct 14, 2003 12:00AM
I have been monitored closely for elevated alkaline phosphate levels and have had a sonogram done of abdomin.( I don't have results yet.) I was told by the tech however, that I have a clear gallbladder. I was trying to see the sonogram, but am not a doc so I found it hard to tell what was what. I did see this gross thing that was all bumpy and sticking up.. for all I know that might have been an organ.
My concern is what this could mean by the way that I feel.
I have no pain in stomach area. I do have persistant pain in my lower back which has been treated months ago with cortisone injections. That treatment did not work. I still have pains going down my left leg as well.
I am EXTREEMLY exhausted all of the time yet have a hard time getting to sleep at night.
My bowels are moving just fine too.
The most recent thing is this hard to explain feeling that is going through my whole body all the time. It is like a flutter. Kinda like when you have a funny feeling about something, like excited or scared. It's almost like a shiver.
Do any of these things have anything to do with each other or anything???
I have read a lot about possible problems, but have yet to find anything about symptoms.
Please help...stressed out.
My concern is what this could mean by the way that I feel.
I have no pain in stomach area. I do have persistant pain in my lower back which has been treated months ago with cortisone injections. That treatment did not work. I still have pains going down my left leg as well.
I am EXTREEMLY exhausted all of the time yet have a hard time getting to sleep at night.
My bowels are moving just fine too.
The most recent thing is this hard to explain feeling that is going through my whole body all the time. It is like a flutter. Kinda like when you have a funny feeling about something, like excited or scared. It's almost like a shiver.
Do any of these things have anything to do with each other or anything???
I have read a lot about possible problems, but have yet to find anything about symptoms.
Please help...stressed out.
Doctor's Answer
by Kevin Pho, MD, Oct 17, 2003 12:00AM
, Oct 17, 2003 12:00AM
Thanks for your patience. With the popularity of the forums and the fact that my own practice has been running in overtime, I try to get to all questions within 5 days.
The elevated alkaline phosphatase can indicate either a liver or a bone problem. In liver conditions, one usually sees a concurrent elevation of the GGT. Ask your doctor to order the GGT as this value will direct subsequent testing.
If your problem is in the liver, there are several possible explanations. Fatty liver, associated with diabetes mellitus, can cause asymptomatic elevation of the liver tests. Obstruction of the bile ducts must also be considered. The best first step is an ultrasound of liver, gall bladder, and bile ducts. This test will often provide information regarding diagnosis. With your ultrasound being negative, this is less likely to be the cause.
With the back pain radiating down the lower leg, one should consider sciatica as a possible consideration. If an MRI has not been performed, that should be the next step - considering this has been going on for months.
As for the "fluttering" feeling, this is unclear without further examination. Basic tests such as electrolytes, blood count, thyroid tests and liver function tests would be a good start. If the fluttering is coming from the heart (palpitations), then an EKG and possible event monitor (a monitor to measure the heart rhythm during these periods of fluttering), can be considered.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
The elevated alkaline phosphatase can indicate either a liver or a bone problem. In liver conditions, one usually sees a concurrent elevation of the GGT. Ask your doctor to order the GGT as this value will direct subsequent testing.
If your problem is in the liver, there are several possible explanations. Fatty liver, associated with diabetes mellitus, can cause asymptomatic elevation of the liver tests. Obstruction of the bile ducts must also be considered. The best first step is an ultrasound of liver, gall bladder, and bile ducts. This test will often provide information regarding diagnosis. With your ultrasound being negative, this is less likely to be the cause.
With the back pain radiating down the lower leg, one should consider sciatica as a possible consideration. If an MRI has not been performed, that should be the next step - considering this has been going on for months.
As for the "fluttering" feeling, this is unclear without further examination. Basic tests such as electrolytes, blood count, thyroid tests and liver function tests would be a good start. If the fluttering is coming from the heart (palpitations), then an EKG and possible event monitor (a monitor to measure the heart rhythm during these periods of fluttering), can be considered.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
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Thank you again.