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Elevated liver enzymes with pain?
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Elevated liver enzymes with pain?

About 2 months ago, after eating dinner, I had an intense pain in my stomach area which lasted about 3 hrs.  This was the 2nd time a pain like this occurred within the past 6 months or so.
I was also having symptoms such as intense nausea, abdominal cramps, diarrhea, and back pain...not always all together but on occasion.  I had a blood test.  I had elevated liver enzymes and bilirubin in my urine.
Since then, I've had an ultrasound which was normal, an endoscopy which was normal and a cck hida scan...which came back normal but the symptoms are still here.  
Now, my doctor is considering an ERCP.  
Do you have any insight as to what all this might be?
I'd appreciate any information you could give me.  
Thank You!!
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6 Comments
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28293_tn?1213140550
You might want to take a look at this page:

http://gastroresource.com/GITextbook/en/chapter1/1-15.htm

Bilirubin in urine is conjugated (direct) bilirubin.
Then, the doctor looks at your liver enzymes to see which ones are high.
Generally,
Bilirubin in the urine with high AST and high ALT....can sometimes be a liver problem.
Bilirubin in the urine with high GGT and high alkaline phosphatase....can be due to obstruction/ cholestasis

You might also want to look at these pages:

http://labtestsonline.org/understanding/analytes/bilirubin/test.html

http://thriveonline.oxygen.com/medical/library/article/003479res.html

Be sure to tell your doctor any drugs that you take (even over the counter drugs, herbs, anything).....and whether you drink alcohol.
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Avatar_n_tn
Hello,
Every thing you have said would lead me to say you could have been passing gallstones. The symptoms are identical to mine and the pain was every 6 months for 2 years, this was because I was told that it can take 6 to 10 months for gallstones to form, and eventually you pass them, so if they scan you just after the attack they will not find anything, as they were doing with me. Be very carefull I was pushed from a surgical doc to a Liver specialist because of my high liver enzymes, but two years later I developed Pancreatitus (pancreatitis) and I almost died. My amylase, which should have been 150 were 2000. I had 3 ERCPs and was told there were no stones and because they could not find stones they told me it was Gilberts Syndrome. When you get the pain again, look out for  dark urine, itching and jaundice,I am due to have an MRI scan on Tuesday morning as this is the only way to detect if there is sludge or stones that have been caught in the bilary ducts. Also you must eat a fat free or low fat diet until they can give you a diagnosis, as easting high fat will only give you more pain.
imkindly is spot on with the bilirubin in the urine, I had an obstruction which caused all the above, don't leave these symptoms as it can get worse.  good luck let me know how you get on.
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Avatar_n_tn
Have you have a catscan of liver yet.  My liver is swollen with a normal liver panel.  People that have swollen livers usually have abnormal liver panels.  

An ultrasound and catscan of the liver might be beneficial to see if it is swollen and to check for many other things.

cwendyhawk
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Avatar_n_tn
Hello,
I have just had my 3rd visit from that horrible pain associated with what I believe are gallstones passing. I am 57 years old. My first time was in Nov 1997. An ultrasound showed nothing. Blood test showed elevated AST level (140) I believe < 35 is normal. I had my second attack this year mid March and then another on April 25th. Right now my AST is elevated again to 351. I also have an elevated white blood cell count of 14,000. The pain each time has lasted from 3 to 6 hours and was followed by a fever as high as 103 that lasted from 24 to 48 hours. The feeling of fatigue lasts about a week or slightly longer. My dr has also tested Pancreas function and all has been normal. He is not 100% convinced that it is gallstones but that of course is the most logical cause. I hope this info is useful to someone and as my diagnosis progresses I'll post other comments.
My prayers are with you all
Take care
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Avatar_n_tn
Hello,
I had my gallbladder removed about 4 months ago and about one month later i started having the same kind of pain.  I have seen tons of doctors.  The did mri's, ct scans, ultrasounds, endoscopy, and an ercp.  I got pancreatitis from the ercp and my liver enzymes are elevated and have been the whole time but they have not mentioned anything about my liver until just a few weeks ago and now they want to do a liver biopsy.  Anyway, I am almost in constant pain but if I had it to do over again I would not get the ercp done.  The pancreatitis is very painful and you are not guarenteed to be over in 48 hours as they told me I would be. Good luck
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Avatar_n_tn
I was very interested to hear you comment about the ERCP and pancreatitis.  I'm extremely skeptical about having an ERCP (even though doc says it's essential).  The risk of pancreatitis is quite high, 15% I think, and it is a very painful disease.  I'm sorry to hear you got it. But I'm glad to have this forum and glad you spoke out about it...cause now I will not go for the ERCP.
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