HI! I have been having upper gastric pain for some time now. Over 2 years on and off. Now it is constant, and after I eat anything it immediately hurts. There is nothing that will take away the pain. I was recently told that I have had mildly elevated SGOT and SGPT. I do not know the numbers, but do know I was always LOW. I get lab work done every two weeks so the doctor has a good barometer. My LDH has been slightly elevated also, this for years. It is high 220-260's. I still have a gallbladder and worked at one point in the 1980's in a medical lab. I am due to get a gallbladder ultrasound. The last one I had said I had a constricted gallbladder, and the previous the same...and I did not eat 8 hours prior. I have occasional naseau and vomiting. I am not jaundice and have had mono in 1988. I am 38 years old and female...I never smoked or drank. I am not sure if this gallbladder ultrasound is the right course...but I have found so much about this pain and mildly elevated OT and PT's....I am so confused.
Thanks for reading this.
You note upper gastric pain with mildly elevated liver enzymes. There are several considerations. Causes can include dyspepsia (caused by inflammation of the stomach or esophagus, GERD, or an ulcer), gall bladder disease, pancreatitic disease or cancer.
With elevated liver enzymes, an ultrasound is not unreasonable. If there is no evidence for gallstones, then a HIDA scan with CCK stimulation may be considered to evaluate gall bladder function (if the gall bladder ejection fraction is low, then removal of the gall bladder may help). The ultrasound would also examine for any liver disease (i.e. fatty liver). I would also test for hepatitis and obtain iron levels and ferritin for hemochromatosis.
If the liver route is non-revealing, I would evaluate for the causes of dyspepsia (i.e. inflammation or an ulcer) with an upper GI series or upper endoscopy.
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.
Thank you Kevin, MD...your comments are right along the line of my gastroenterologist. The abdominal ultrasound was normal..no stones in the gallbladder or ducts. I will be having the nuclear medicine gallbladder emptying scan and enzyme injection next Tuesday. I did also find out that my Alk Phos is elevated and has been for over a year now. The pain is still there...always in the background and real bad if I eat or lay down. My EGD for motility was fine...have had in the past a bleeding stomach ulcer...that is fine. Thanks again.
Just wondering how your HIDA scan came out. I have a similar history to yours. Still have gallbladder, have had a lot of right upper quadrant pain, elevated liver enzymes, no gallstones on ultrasound, CT, and MRCP (MRI of bile ducts). I had a 33% ejection fraction on HIDA, which is marginally abnormal, so doctors aren't too excited about taking out my gallbladder at this point with such confusing results. Just wondering what your findings were.
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