Lingering Pain After Hepatitis Recovery

I am a 42 year old female, otherwise healthy, recovering from hepatitis with an unknown cause. It started with what seemed like the flu 3 months ago.  I developed dark urine and light colored stools and was admitted to the hospital--hep screens (A-E), cytomeg, EB virus all neg.  Autoimmune antibodies were negative.  Contrast CT scan, MRCP showed nothing remarkable--was told it was either a reaction to Bactrim I took for ear infection or unknown virus.  At their peak: AST 177,ALT 358, ALP 294, GGT 77.  Total bilirubin slowly rose to 12.  I was jaundiced, fatigued and had moderate itching, especially at night--Actigall was prescribed.  I saw liver specialist who scheduled biopsy just in case but advised watchful waiting with weekly bloodwork.  Almost immediately, enzymes began falling, as did the bilirubin.  At last check all enzymes were within or near normal limits and bilirubin was 1.1, biopsy was cancelled. I look and feel well, have long since resumed work and exercise.  Stools and urine look normal, appetite is good and I am sleeping well.  

My concern is that I continue to feel some discomfort (mild ache or cramping) in RUQ, front and back.  It is intermittent, not severe, does not interfere with daily activity, seems to go away when I go to bed.  I am more aware of sensation now than when I was really sick--that just may be because I felt so lousy before.  I cannot ascertain a pattern as to when I experience this pain.   I have always enjoyed good health with the exception of having my gallbladder out two years ago.  I have refrained from drinking alcohol and taking OTC pain meds since all this began and the only drug I do take is the occasional Benadryl/Sudafed for allergies. I was a moderate drinker and I eat well and stay active as I heal .  My liver specialist thinks this lingering pain is due to the liver healing and the Glissons capsule readjusting since my labs are normal and I feel so good. I do monthly bloodwork now.  Do you  
agree?

[Kevin Pho, MD]

I agree with the testing thus far, and it has been comprehensive.  

Monitoring the liver function on a regular basis is indeed recommended.  If they continue to rise, continuing with the scheduled liver biopsy is the appropriate next step.

If the liver is normal, an upper endoscopy can be done to exclude other causes of the abdominal pain you are experiencing.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com