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Pressure In Side

  Thank you for this opportunity to ask questions.
  I have been suffering with problems for about eight years now.
  A quick history:
  I am 44 female
  Abnormal Liver Tests 1990 -  High alk phos, symtoms of unwellness
   and terrible fatigue, right upper quadrant pain and pressure
  Liver Biopsy -  not significant
  Gall bladder removed 1991-  inflamed but no stones, continued to
   have pain
  one month after gall bladder removed had EPRC and sphinterotomy
  of bile duct
  continued to live with pressure in my side with intermittent pain
  had second sphinterotomy done.
  None of this has really resolved the problem and I have just
  lived with a feeling of a red hot bowling ball in my side for the
   past eight years.
  I have had intermittent times of low grade fever and chills.
   I have not gotton any worse but neither have I improved.
   I continue to struggle with fatigue on a regular basis and
   at times my skin hurts all over.
  My doctor has continued to monitor my liver and called me
   recently to say she was very worried about my last results as
  now my AST is showing high as well as my alkphos.
  She sent me to a liver clinic in Toronto and my next appointment
  is in a few weeks for an ultra sound. They wanted to see my liver
   biopsy from eight years ago to have  "their own people look at
   it" My questions
  Do they expect to see something on a past biopsy that the last
   hospital didn't see???
  Why do I have such bad pressure in my side?  Not pain but
  pressure.  Can this be a result of problems with the ducts.
   Can the liver feel pressure?
  How can I go so long with just the two main symtoms
  of pressure and fatigue lots of tests and no diagnosis.I have
   never been jaundiced or itchy for example.
Dear Karen,
1) Not all pathologists have the same degree of familiarity with liver disease.  having an expert review a biopsy is always worthwhile, although they may not make any new diagnoses.
2)I do not know why you have your right sided abdominal pain.  An enlarged liver e.g. due to fatty infiltration can produce an aching sensation on the right under the ribs.  Ductal obstruction usually produces a more severe pain than that which you describe.
3) You should discuss with your physician the possibility that other conditions e.g. intestinal disease, dysmotility are the cause for your symptoms.  Maybe the problem is not the liver despite the increased liver tests.
This information is presented for educational purposes.  Ask specific questions to your personal physician.
If you wish a second opinion, we would be happy to see you in the Division of Gastroenterology of Henry ford health System in Detroit.  you can arrange an evaluation with Dr. Fogel, one of our experts in gastrointestinal disease, by calling (800)653-6568.
*keywords: elevated liver tests, abdominal pain

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