My alk phospay=te levels keep going up and down

[DDinATL]

I have no gallbladder and in dec. of 07 my alk phospahte level was 178 and in june 08 it was 122, I also have ANA positve result 1:4 not sure what all this means, but I hurt so bad on my right side just below my rib cage and my stomach often gets destinded (not sure of the spelling sorry) I also have had itching problems mostley on the bottoms of my feet and in my hands and I am not very active due to lack of energy, I slepp through the weekend just to make it through the week. When I was 18 I had hepitis A if that helps at all. Last year I was alos told I had gastropereses (again not sure of the spelling. Please help me to determine which kind of doctor I need to see. I am worried I my have PBC.
Thank you very much!!

[Thomas D Schiano, MD]

without question I think that you should see a gastroenterologist (GI specialist).  A simple blood test called AMA is (+) in 90% of people with PBC so is a good screening test.

i hope this is helpful.

[Thomas D Schiano, MD]

you had an ERCP which apparantly was normal.  You have not had an AMA test (you had an ANA test), so you should have one.  Not sure you did a liver biopsy right now until you get the appropriate blood tests which should also include a GGTP and IPEP.

[DDinATL]

I thought I would type out what my blood work actualy says:
"Although the specimen was positive for Anti-Nuclear Antibodies (ANA), the presence oof Cyoplasmic Fluorescence was noted on the Hep-2 Slide. Other reactives (E.G., Anti-Mitochondrial Anitbodies or Anti-Smooth Muscle Antibodies) May be responsible for this Fluorescence."

Can you please help me understand this please?? I have called my PCP asking that I have a liver biopsy done and she has yet to call me back, also I was seeing a GI doctor about a year ago and he did an different type of Endoscopy on me were I was laying on my stomach and checked out my bile ducts to see if I had a blockage and said I had Gastropareses. No care after that and didn't seem to be very concerned or helpful.
Thanks so much again for your quick response this is helping me understand alot. One more thing I get real confused at times and I have bouts of vomiting and it is all bile (yellow stuff) that comes out.