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Back pain, done blood work, history of IBS, GERD and hiatal hernia. Is it a matter of concern?

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Practicing since : 2004
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I have had a recent blood work up and had some concerns. My ALT was 93 U/L and my AST 28 U/L. My Alkaline Phosphate is 122 U/L. My Total bilirubin is 2.1 mg/dL and direct bilirubin 0.4

Wondering how concerning this is and if it deserves immediate attention?

I also have been having back pain recent and got me reading about kidney, pancreatic, liver cancer, etc. The pain is not super bad just started about 3 weeks ago. Its on the left side under my rib cage and some times will radiate down into the top of my left glute. So I related this with my blood work got me worried. But I also heard if it was any bad cancer that the pain would be emergency room type pain. Not sure how true that is. Plus someone said I am 34 and young for a lot of types that I mentioned. And that a lot of those levels I mentioned would be extremely high if I had anything bad going on. You would know about that more then me.

I also have a history of IBS-had an upper GI about 5 years ago and said I had a hital hernia and GERD.

I have had 4 sets of blood work over the last 4 years and the bilirubin levels have always been total of 2.1 or 2.2 and direct was 0.4. So over the last 4 years it has been about the same. But the ALT was raised just in the last blood test last August.
Posted Mon, 21 May 2012 in Lung Cancer
Answered by Dr. Indranil Ghosh 19 hours later
Thanks for writing in.
A bilirubin level of 2.1 mg% with direct of 0.4 only points to possible XXXXXXX syndrome in you. It is a benign disease and does not lead to liver dysfunction. It is a hereditary abnormality in bilirubin metabolism but is harmless in the long run.
Your laboratory values are not something you need to be alarmed about as laboratory test results should always be looked at as a part of a larger clinical picture.
The single raised value of alanine aminotransferase (ALT) is not alarming to me as you are otherwise healthy and only a social drinker. It needs follow-up only.
The back pain may be due to benign causes like musculoskeletal spasm. I am not too concerned for it and cancer is a very unlikely possibility in you. But to be on the safe side, you may get an ultrasound of the abdomen done. Most likely it will be normal. In that case, the pain can be relieved by hot fomentation and a diclofenac ointment which can be applied locally at the site of pain.
Hope I have answered all your queries. I will be available for further follow-up queries, if any.
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