What is the likelihood that I have a gallstone stuck in my bile duct?
I had my gallbladder removed on 3/21/13 and the week following surgery I felt great. The past two, however, I have felt extremely nauseous, all day every day. My doctor did the four liver function tests and all results were normal except the ALK PHOS test. My level was 132. At the time, I had not been experiencing any pain, so the doctor said that he didn't believe I had any remaining stones. He said that if you are obese (which I am), your level can be elevated. For the past several day, I have been experiencing the same pain I had prior to surgery, but to a bit lesser extent. It feels like I have had a couple of small attacks. The pain is in my right rib, upper mid / right side of back, and in my chest. Today I was vomiting. My question is about the likelihood of having a stone in my duct. Being that my level was only slightly elevated, is it likely that I have a stone or not? I have requested my doctor contact me so I will follow up with him, but would appreciate any feedback anyone has.
Additionally, my MPV level was slightly elevated as well (11.2). Could the two be connected? I read that elevated levels for both can mean hyperthyroidism. I've been checked for this twice in the past year, but my TSH levels have been normal. I know you can still have issues even though the TSH tests are normal, but what is the likelihood of that? For the past year I have been excessively hot, sweating more than normal, had a low-grade fever, tremors in my hands, anxiety, insomnia, and now for the past month or two, heart palpitations....all symptoms of an overactive thyroid, but is it likely with my levels being only slightly elevated, that this could be what has been causing me those problems this past year?
The most common reason for recurrent pain soon after gallbladder surgery is sludge or stones that have passed down the main bile duct. This is typically evaluated by repeating your liver function tests and obtaining a MRCP. An MRCP would be preferable to an ERCP in this situation. This is merely a specialized MRI scan which doesn't require any scopes be inserted or tubes placed up the bile duct. Your surgeon needs to know about your symptoms.
In sub clinical forms of hyperthyroidism, there may not be elevation of thyroxine (T3 & T4) levels, but there can be a reduction of TSH levels. Palpitation and tremors can be seen with anxiety also. But it may be worthwhile to check your thyroid status again after 4 weeks.
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