I hope this is the right place to post this....

A few days ago, I posted the following under the general GI forum. Originally, I wanted to know if I should just talk to my doctor, as you'll read in the post after the dashed lines.I got back one response, which said to look in to something called NCS (neurocardio syncope)?  I don't know much at all abut NCS and I was wondering if I coud get any more information?

I apologize for how long this post is. But please, read over these symptoms and see if this matches NCS, or anything?

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I have some GI problems already and I see my doc in February. He has me keeping a diary of my symptoms so we can try to pin a diagnosis. I was filling it out the other day and noticed this pattern of nausea followed by heart rate changes. The nausea is always really sudden---I could just be doing homework or watching TV and this happens---and then it feels like I just ran a marathon. My breathing increases a little bit, but I don't feel warn or sweaty.

I have also been noticing lower back pain, right around the top of my pevlis, in that sort of area...

When I was in middle school, I used to see a cardiologist because I would faint, and they thought it could be something with low blood pressure. Now, I do have low blood pressure and an electrolyte problem, but even back then, I never had symptoms like this. That's the reason I was discharged from the cardiologist and told to consult my PCP is something happens again.

The GI symptoms I normally have are lack of appitite, upper right abdominal pain, elivated liver enzymes, diarrhea, and vomitting. My GI specializes in liver disorders because we're pretty sure that's what's going on...

What do you guys think? Should I bring this up to my GI or not? .

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Thanks for taking the time to read over this and I appriciate any information I can get!

~ Em

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Persistently elevated liver enzymes need further investigations like imaging studies and if needed a biopsy to determine the cause for the elevated enzymes. More so, since you have associated symptoms of liver diseases like upper abdominal pain, nausea, vomiting and loss of appetite. If you can get back to me with the diagnosis, I will be able to elaborate further.
In the meantime you could follow certain precautions. Avoid smoking and alcohol. Avoid drugs like paracetomol and sedatives. Get vaccinated for hepatitis A and B. Take a good protein diet.

Hope this helped and do keep us posted.

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Persistently elevated liver enzymes need further investigations like imaging studies and if needed a biopsy to determine the cause for the elevated enzymes. More so, since you have associated symptoms of liver diseases like upper abdominal pain, nausea, vomiting and loss of appetite. If you can get back to me with the diagnosis, I will be able to elaborate further.
In the meantime you could follow certain precautions. Avoid smoking and alcohol. Avoid drugs like paracetomol and sedatives. Get vaccinated for hepatitis A and B. Take a good protein diet.

Hope this helped and do keep us posted.

[EmmyJN]

I've had a biopsy already, back in July. They said things looked good so far, that there was thankfully no cirosis. I have regular blood tests to watch my liver enzymes, and they stay the same, but elevated.

My original doctor told me that I might have Non-Alcoholic Fatty Liver Disease and IBS. I was given some medicines to help with the pain and put on a special diet. We cut on a good amount of fat, along with gluten (which I already had an intolerance to prior to these things happening). Last time I had blood work, they ruled out the common autoimmune diseases and the things that are usually looked at when someone presents these symptoms.

The problem we kept running in to was, first, my age. I'm 16, and the GI I used to go to told me that they didn't test for some things (I don't know what) because I'm too young for them. I'd lost 30 pounds, and still the pain is there. Actually, it's gotten worse, not better. My doctor had me track the pain and what I eat. He told me that, according to my diet---which I stick to like religion---and my weight loss, I should be having less pain, not more.

That GI retired and I'm going to be meeting my new GI at the end of next month. I don't know if I'm going to be re-tested for the illnesses again. Do you think I should get retested? I'm always afraid to ask doctors what they checked for, or if they checked for something specific, or to recheck me, because I feel like I'm being a hypocondriack. Trust me, that's not what I am. I just want to get better. But I don't know how to request these things without sounding like I'm trying to get attention.

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Understand your predicament. Non alcoholic fatty liver disease, is due to obesity, diabetes and high triglyceride levels. So, prevention or cure is by avoiding alcohol and treating diabetes, obesity and high triglyceride levels. You can discuss with your doctor to rule the causative factors for Non alcoholic fatty liver disease.

Hope this helped and do keep us posted.

[EmmyJN]

Hello again! I have a quick update for you.

I talked to a new GI doctor (since the man I had been seeing retire) who went back over all my charts. He thinks that my old GI might have missed something, because my  triglyceride levels are healthy, and I've lost a considerable amount of weight (almost 40 pounds). I do not have diabetes, nor am I pre-diabetic or even insulin resistant. He did blood work on me and the liver enzymes were still higher than they should be.

We just did an ultrasound and blood pannel. The ultrasound was for my liver, kidneys, bladdar, spleen, and galbladdar. The blood panel was a liver panel, glucose, triglycerides, testosterone (I don't know why...) and one other things that I cannot remember at the time (sorry!). My new doctor says we need to do these tests over again because he wants recent results. The old results are almost a year old now, and he doesn't think they're reliable for diagnosis anymore.

Because all my old symptoms persist, Dr. T (my new doc) is looking for anything that could require an endoscopy (hope I spelled that right/have the right name) to look at the galbladdar better. He's actually talking about considering removing the galbladdar if anything looks off. (I don't know why he's so adimate about this, but if it's needed, I suppose I will go along with it.) There also may be a repeat of the liver biopsy, if needed.

Right now, I'm waiting for the results of an EKG so I can fill the perscription of .5mg of an antidepressant that's been proven to help with pain in small doses. The EKG is needed because the medication can make underlying heart conditions worse. We're doing pain management therapy and I've been put on a 6 meal a day diet that's low-calorie and low-fat in an attempt to make me lose more weight and see if that helps with the liver whatsoever. It's one big waiting game right now.

Thanks for your help so far, and I will keep you posted.

~ Em