Raised ALT liver function - gallbladder / bile duct related?

[BambinoBoo]

I had a CT scan a month ago for an ongoing gallbladder problem (inflamed). The consultant couldn't see any stones but my bile duct is dilated to 18mm and gallbladder wall slightly thickened. He has now ordered an MRCP (MRI scan) before he decides whether I have a ERCP or something else. In the meantime, my GP had my liver function and blood tested and it has come back today with raised ALT. He wants to repeat the blood test on Thursday. I am worried and not seeing him till tomorrow. Does anyone know please if a raised ALT is typical with problems with the bile duct or gallbladder - the latter of which I am still waiting to have out; although it seems that the bile duct is now the primary issue. Have googled and it keeps saying raised ALP for bile duct and ALT for alcohol use - not touched a drop in months and I wasn't a heavy drinker before that.

Many thanks

My ALP and ALT are finally dropping, but still very high, but now my GGT is over 400. Not sure what this means.

Boo - Haven't been around for a while but must have got 6th sense and looked today!

Glad you have had your MRCP and that your LFTs are settling. If you have a stricture under the stone that explains why it had got stuck and was causing you so much pain. It can be fixed - don't worry!!

Your GP's plan sounds sensible; if you are asymptomatic (without symptoms such as pain, significantly raised LFTs etc) then you will be safe left until the end of Feb for a futher review. Your Consultant may well not have seen the result yet, it may be in the pile for Monday. That's a good thing - investigations that show a possible "nasty" get highlighted quicker.

Things like this can drag on for a while. It's because you are in the bracket of needing some medical care but because it's not an emergency or a possible cancer that needs prompt attention it can take a few weeks to get to you in the queue. If your condition changes though, so will your place in the queue; your GP can liaise with the hosp to arrange this.

Hang in there, you are doing well

Stars If your numbers are generally dropping,thats good; don't worry about GGT still being up. Its an inflammation marker so will be up still if you had a nasty drug reaction. (What did they put it down to, just to be nosey?!) It can take a heck of a while for a person to recover.

Bilirubin and Albumin are features of actual function, (AST, ALT, GGT being inflammation) so if they are OK then your liver won't be failing.

Are you still in hospital? Bet you are bored rigid with it by now

Many thanks purple I think my consultant must have seen my mrcp results yesterday as I got a call this morning from endoscopy asking me to come in on thursday for an Endoscopic ultrasound. I'm really trying to tell myself that all the consultant wants is a better picture at what is below the stone as the mrcp couldn't visualise it - although the radiologist hinted at it being a stricture. Like an idiot, I bloody googled and wished I hadn't. All the nurse said is that the consultant wants to do this before ercp and lap choly. I'm worried by the quickness of it all, but my DH said that he probably wants to gather as much info before the outpatients appointment in 2 weeks more than anything so he can give me a definite course of treatment. Had bloods today and should have results tomorrow so am trying not to panic yet. Thanks again though. You're a star.

Boo Your DH is right!

If you went to the OPA in a couple of weeks and then the Consultant said he wanted more tests you'd be banging your head on the nearest wall. Sounds like they are being observant and on the ball and that the process of care is good, and that you are simply moving up the queue as the people in front of you have been dealth with.

It's normal to worry and almost impossible not to; I'm not going to patronise you and say "don't". Google can be a pain in the arse at times like this; just don't go there!

Let us know tomorrow how you are

purple Thank you again. You are right, and so is DH probably, although I'll keep that to myself I guess we'll see what this EUS shows and take it from there. In the meantime, i'm going to try and stay off google. DH is threatening to confiscate my iPad.

Yay. LFT back to normal, but gamma still very slightly raised to 52 but that's a massive improvement on 238. Looks like the gamma has come down in line with the inflammation reducing which makes sense. EUS tomorrow. literally! Thanks for putting my mind at rest purple and of course for explaining the test results.

Hope your Gamma is soon on the way down too stars All these tests and the waiting get you down don't they.

Boo Fantastic!

Have fun tomorrow, its all nearly over now!

I'll try to enjoy tomorrow purple , hoping I'll get the sedative and nap through it all.

Hi Bambino. I get my results within two hours of the test so dont have the wait, but I am also being tested every day anyway. My liver is the most affected organ, but doctor doesnt seem too concerned. Was very inflamed and painful for a while but this has settled now. GGT 365 yesterday so this is rising, but the other results are dropping. Doctor only seems concerned about bilibruben levels.

I am sure once I stop taking so many drugs everything will be ok.

glad to hear you are getting better though

It was a liver function result like that that had my incompetent doctor telling me I was an alcoholic (diagnosed apartly 'due to my ethnicity') when in fact I had gallstones, which were identified using an ultrasound (I had previously been sent for a barium swallow as the doctor thought I had given myself an ulcer with my 'drinking'). I had laparoscopic surgery for the gallstones and it turned out there was a stone in my bile duct - the operation took much longer than expected while the surgeon pushed it through.

The surgeon wrote a humdinger of a letter to the doctor who said I was an alcoholic with a pickled liver.

Good luck -- I hope you'll have your surgery sooner rather than later. I felt better immediately (as soon as I was healed anyway).

Everything on the web points to GGT being alcohol related. As I havent touched alcohol for a year now I now this isnt true.

Hi stars and mathanxiety as purple said, high GGT is a marker for inflammation. For a doctor to continually suggest that it's alcohol related isn't helpful and really lazy care IMO. stars did you find out what was wrong in the end, is it drug related or did they look into the bile duct obstruction?

purple I had my endoscopic ultrasound yesterday. Doctor and nurses were fab and really put me at my ease. Weird outcome though, the doctor said that the stones in my CBD are highly visible and will make fantastic teaching images, but after trying different angles and getting as close as he could, he couldn't see a stricture. Said there could be a narrowing but he thinks that it could be my natural make up so is all a bit odd. Now up to my consultant to decide what he wants to do. I'm guessing ERCP next to get the stone out.

Hi Bambino. Yes I had a bile obstruction, all my intestines/bowels/liver were inflamed, probably still are. The doctor keeps saying its my medication and it will settle down. Now that it is, they seem happier, yet never indicated it was such a problem. I only knew how high the figures were because I got copies of the blood results. All along they kept saying everything was ok. Am also on high dosage of steroids. results dropping because I have reduced dosage slightly over last week.

Will be so glad when medication ends. It is such a chore.