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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 42794
Experience:  Board Certified Physician
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Hi I wonder if you could help me. I started having episodes

Customer Question

Hi
I wonder if you could help me. I started having episodes of severe abdomen pain under my ribs/just above my naval in the early hours of the morning and then more colicky pain less severe the next day sometimes with bad acid reflux I had 3 episodes of this before going to my doctor. My doctor sent me for a blood test and my ALT came back as 360 CRP 114 I was sent to the hospital immediately for a repeat blood test I do not know what the results were but they discharged me as they said my results were better the they were previously but I needed a follow up by my GP I was sent for a urgent liver/Gallbladder ultrasound and another blood test to test for Hepatitis, HIV, Toxmosis, Glandular Fever. All the blood tests came back clear and the ultrasound found some small gallstones but liver was ok. My latest blood test shows my ALT as 120. My doctor thinks finding the gallstones was a coincidence and it might not be the cause of the pain. I am now getting the pain more frequently at least once or twice a week but the pain is less severe although still really hurts it can last for anything from half an hour/an hour to all day off and on it is during the day not night and can happen even if I haven't had much to eat and what I have had wasn't fattening. I am due to have another blood test next week before the doctor decides what do to next but I would appreciate a second opinion if this could be the gallstones causing the pain and high ALT. Many Thanks.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. David replied 2 years ago.

Dr. David :

This is Dr. David

Dr. David :

yes, passing gall stones out of your gall bladder could definitely be causing your right upper quadrant abdominal pain and causing elevation of your liver enzyme levels.

Dr. David :

passing gall stones can also cause temporary elevation of your CRP and ALT levels as well.

Dr. David :

you are a bit young to have gall stones, but it can still happen.

Dr. David :

there are medications which an help dissolve gall stones. like ursodiol which could help you to dissolve gall stones and help prevent future pain.

Dr. David :

I would also ask your doctors for a HIDA scan to check for gall bladder function.

Dr. David :

your gall bladder may not be functioning properly.

Dr. David :

hello?

Dr. David :

do you have other questions?

JACUSTOMER-2x1jqvl6- : Sorry Dr David for the delay in my reply, Thank you for your answer, I have a few questions though my Doctor thinks that it is not gallstones as he said the liver blood results don't go in line with gallstones cause as it is not normally the ALT that rises or rises that high - second opinion please. Also When I have the pain my abdomen feels very tender however without the pain it feels normal which is very hard when a doctor examines me without the pain and says my abdomen is normal because I know with the pain it isn't. Also is it normal that the pain has changed in place (more above belly button then under ribs) and in intensity (less intense) in the last month?
JACUSTOMER-2x1jqvl6- : Also Dr what is a HIDA scan what tests would be done to ascertain if my gallbladder is working properly? Would they take my gallbladder out due to the gallstones?
Dr. David :

your over tests have been negative for hepatitis and other issues.

Dr. David :

passing a large gall stone can sometimes bring up your liver enzymes temporarily.

Dr. David :

your ALT is coming back down.

Dr. David :

you might need more liver imaging like a liver MRI scan or liver ultrasound. but you said the liver ultrasound was basically negative.

Dr. David :

gall stones can do this. cause intense pain for a short period of time and then back to normal.

Dr. David :

have you had severe constipation? constipation and diverticulosis can do this as well.

Dr. David :

HIDA scan can tell if your gall bladder is working properly or not.

Dr. David :

you don't remove the gall bladder just for gall stones. these can be dissolved by medication like ursodiol

Dr. David :

however, if you continue to have these pain episodes in the right upper quadrant and everything else has been tried, you have tired the ursodiol, you are not constipated, you have had a colonoscopy and liver MRI scan and nothing else explains these pains, then removing the gall bladder might help as a last resort for you.

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