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Gastroenterology (Expert Forum)
High tot. bilirubin, albumin and pain in the left side of the abdomen
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
High tot. bilirubin, albumin and pain in the left side of the abdomen
by sakoul, Nov 08, 2006 12:00AM
hi,
my story is a bit complicated. Two years ago i started feeling a pain on the left part of the abdomen. To be honest, i was taking some hair prescription (vitamins and another kind of pills, given by my physician in Greece) and i use not to follow my physician's orders (use to have the prescription late at night, one hour before i sleep, with not much water). So i visited a physician here in US and he ordered a CT scan of the abdomen (March '05). Everything was clear except for the fact that the spleen (which i think is on the right part of the abdomen) had a cephalocaudal length of 13.5cm which was in the upper limits of the normal in size (please keep in my i am Male, 28yr, arround 6-2 and ~165 pounds). Moreover, that March i did a blood and enzyme test. The physician TOLd me he did not find something negative. So i waited to see any future development of the pain. The pain kept being present. SO in August '05 i went to another physician and REDID CT scan of the abdomen. I intentionally told him to measure the volume of my spleen and he said that THE VOLUME value was normal and the scan negative. So i waited again to see what will happen. To short up things, the pain is present till these days. Yesterday, i visited my original physician (March '05) and he told me that in the blood tests of '05 the tot. bilirubin were 1.9. So we ordered another blood test and enzyme. The enzyme test results are:
Glucose 87mg/dL
BUN 15
Creatinine 0.8
Sodium 141 mEq/dL
Potassium 4.4
Chloride 102
CO2 27
Anion Gap 16
Calcium 9.9 mg/dL
Tot bilirubin 1.8 (recall that they were 1.9 in '05)
Alk Phosphatase 73 IU/L
AST 28
ALT 20
Total Protein 7.9 g/dL
Albumin 5.3
Globulin 2.6
GFR (Calc.) 127
My initial physician believes everything is right BUT I ONLY TRUST MY PAIN AND MY INSTICT. During the last year i quited smoking and i started working out and to be honest i do not feel anth during working out. I have scheduled an ultra sound for the abdomen for tomorrow but i would like to ask you (in case the U.S. is clear) do you suggest any other short of check up (LIKE liver biopsy or some spleen exam, gallbladder or or). I am really looking forward to hear something from you.
Thank you very much
my story is a bit complicated. Two years ago i started feeling a pain on the left part of the abdomen. To be honest, i was taking some hair prescription (vitamins and another kind of pills, given by my physician in Greece) and i use not to follow my physician's orders (use to have the prescription late at night, one hour before i sleep, with not much water). So i visited a physician here in US and he ordered a CT scan of the abdomen (March '05). Everything was clear except for the fact that the spleen (which i think is on the right part of the abdomen) had a cephalocaudal length of 13.5cm which was in the upper limits of the normal in size (please keep in my i am Male, 28yr, arround 6-2 and ~165 pounds). Moreover, that March i did a blood and enzyme test. The physician TOLd me he did not find something negative. So i waited to see any future development of the pain. The pain kept being present. SO in August '05 i went to another physician and REDID CT scan of the abdomen. I intentionally told him to measure the volume of my spleen and he said that THE VOLUME value was normal and the scan negative. So i waited again to see what will happen. To short up things, the pain is present till these days. Yesterday, i visited my original physician (March '05) and he told me that in the blood tests of '05 the tot. bilirubin were 1.9. So we ordered another blood test and enzyme. The enzyme test results are:
Glucose 87mg/dL
BUN 15
Creatinine 0.8
Sodium 141 mEq/dL
Potassium 4.4
Chloride 102
CO2 27
Anion Gap 16
Calcium 9.9 mg/dL
Tot bilirubin 1.8 (recall that they were 1.9 in '05)
Alk Phosphatase 73 IU/L
AST 28
ALT 20
Total Protein 7.9 g/dL
Albumin 5.3
Globulin 2.6
GFR (Calc.) 127
My initial physician believes everything is right BUT I ONLY TRUST MY PAIN AND MY INSTICT. During the last year i quited smoking and i started working out and to be honest i do not feel anth during working out. I have scheduled an ultra sound for the abdomen for tomorrow but i would like to ask you (in case the U.S. is clear) do you suggest any other short of check up (LIKE liver biopsy or some spleen exam, gallbladder or or). I am really looking forward to hear something from you.
Thank you very much
Doctor's Answer
by Kevin Pho, MD, Nov 09, 2006 12:00AM
, Nov 09, 2006 12:00AM
An elevated total bilirubin in the face of other normal tests and imaging studies can be caused by Gilbert's Syndrome. Typically, this does not need to be treated, and is unlikely to be the cause of the pain.
On the left side of the abdomen, the spleen as well as various upper GI disease can lead to the symptoms. Splenic disease would be less likely in the face of a normal CT scan.
You can consider an ulcer or inflammation of the upper digestive tract. An upper endoscopy with H Pylori testing can be considered to evaluate for this possibility.
An ultrasound would be less helpful given the fact you have had several CT scans in the past.
These options can be discussed with your personal physician.
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_
On the left side of the abdomen, the spleen as well as various upper GI disease can lead to the symptoms. Splenic disease would be less likely in the face of a normal CT scan.
You can consider an ulcer or inflammation of the upper digestive tract. An upper endoscopy with H Pylori testing can be considered to evaluate for this possibility.
An ultrasound would be less helpful given the fact you have had several CT scans in the past.
These options can be discussed with your personal physician.
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_
Member Comments
by Scooch, Nov 12, 2006 12:00AM
My father is 78 years old and has had severe stomach pain since july. We have been to several Dr's as well as the ER twice. He has had CT scan ultasound, and xrays,he is an insulin dependent diabetic, prostate cancer surviver (1 1/2 years cancer free) and has ostio-arthritis and recently had an injection of marcaine and kenalog to ease the pain(that has worked very well)every test he has taken has come back and negative,he has had several severe falls where he has fallen pretty hard, due to the pain in his stomach.The pain has not eased, pain medication (darvocet, soma) does not seem to help much.His stomach appears to be swollem and hard and he has a lump that seems to radiate from the left to the right side, today it looked like a baby moving in his stomach(I am not kidding) We are at our wits end and really do not know what to do? He is starting to give up and I am wondering if maybe we are not asking the right questions. Has anyone heard of this and can you give me some insite. I would really appreciate any help at all
