Liver/gallbladder

I am a 49-year-old female with a history of CHF, DCM with return-to-normal function (EF 55%), insulin-dependent type 2 diabetes, mellitus, HTN, hyperlipidemia, obesity, and obstructive sleep apnea who was diagnosed with nonfunctioning gallbladder by HIDA scan with EF.  No stones were noted by ultrasound or HIDA scan.  I was instructed to proceed with cholecystectomy.  However, my surgical risk is moderate due to the above medical Hx.  So, I have chosen not to undergo surgery and to live with the associated pain which is mild to moderate for as long as I can.  

Over the past few days I have noticed that my stools appear pale colored and that the pain is a little more noticeable.  Also, during all the above testing my AST/ALT have been elevated, though, not significantly (ALT 65 and AST 52).  This of course really worried me, and I have asked several of my medical providers why, and they have not been able to answer this question.  Yes, I did try statins which raised my AST/ALT a little higher so they put me on Zetia.  I also take Avandamet 4/1000 mg twice a day along with Lantus insulin 40 U q.p.m.  My question is why are my liver enzymes elevated, should I be concerned?  Also, is it really a good idea not to have a cholecystectomy done at this time, and what are the risks to me if I continue to put the surgery off?  Thank you in advance for consider of the abovementioned matters.

[Kevin Pho, MD]

There can be many reasons why the enzymes are mildly elevated.  

The ultrasound would rule out most of the anatomical causes.  You can also obtain blood tests to evaluate for hepatitis.  Alcohol intake and side effects from the medication are also possible.  

Liver function tests at those levels should not preclude surgery.  The tests should be repeated to ensure they are not rising.  

Continued pain from the gallbladder would be the likely result of delaying surgery.  

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.

Kevin, M.D.
kevinmd_b

[Herbs-Wholesale]

I'm so sorry to hear about your pain .If the bile does not flow freely into the intestinal tract, it goes directly into the blood stream and circulates throughout the system causing a toxic condition known as cholemia, producing indigestion, sluggishness, fever, fatigue, constipation, upset stomach, chills, pain and vomiting, among some of the symptoms
Excesses in eating and drinking should be avoided. If gallstones are present and the ducts are blocked, bile may be forced back into the liver and enter into the bloodstream. The skin may take on a jaundiced color. Ultimately, the bile is excreted through the urinary tract. The urine is often dark red or amber color and is very concentrated. Clay color stools are another symptom. During a time of a gall bladder inflammation, heavy eating should not be done. Fruit and vegetable juices are recommended along with the liver-gallbladder herbal formula. The bowels should be kept open and undomesticated through the use of the lower bowel formula.
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