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MoeCo8

Gallstones and elevated Liver Enzymes

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Dr. Callery,

I was just informed by my GI doc that my liver enzymes are elevated. She is sending me for an abdominal ultrasound on Tuesday to rule out gallstones. I have ulcers in my pouch, but that pain is on the left side. Can you have gallstones that effect your liver enzymes with no pain(I know that your gallbladder is on the right)? Thank you for your help!

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Dr. Callery,

I was just informed by my GI doc that my liver enzymes are elevated. She is sending me for an abdominal ultrasound on Tuesday to rule out gallstones. I have ulcers in my pouch, but that pain is on the left side. Can you have gallstones that effect your liver enzymes with no pain(I know that your gallbladder is on the right)? Thank you for your help!

Gallstone related pain is usually in the mid upper abdomen or right upper abdomen and often travels to the area just under the lower tip of the right scapula (shoulder blade). However pain sometimes occurs elsewhere such such as in the left upper abdomen or shoulders. Gallstones can cause elevation of liver enzymes two ways. First, if a patient gets acute inflammation of the gallbladder, the live is affected locally, and certain enzyme levels rise. This type of acute inflammation, called acute cholecystitis, usually causes right upper quadrant abdominal pain. The second way that gallstones can cause elevation of enzymes (different ones) is if a stone escapes from the gallbladder and lodges in the common bile duct. The stone blocks the duct, and puts back pressure on the bile and thus the liver. In this situation the patient may develop jaundice (yellowing of the skin).This process is often painless.

(NMRCP)

Your doc can usually sort these causes out with blood work and an ultrasound. Sometimes more exotic tests such as nuclear magnetic resonance cholangiopancreatography (NMRCP) are needed.

The graphic demonstrating gallstone related problems is from a Krames patient information pamphlet. See also a good article in New York Times Health Guide.

post-4-0-23744500-1307976593_thumb.jpg

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