Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Does Constantly High ALP And GGT Levels Imply Residual Liver Damage?
Question: I was diagnosed with acute pancreatitis in XXXXXXX 2007, which led to acute respiratory failure, kidney failure. I spent some 4 months in hospital (2 months in ICU). While in recovery, I developed obstructive jaundice due to blocked bile duct constricted by swollen pancreas. My bilirubin levels went up and up and a biliary bypass was performed.
Before the biliary bypass, my bilirubin levels was abnormally high, Alk-Phos and Gamma GT in the region of 200 – 300. After the biliary bypass surgery, my bilirubin came down and within 3 months it was normal again. Just after the bypass surgery, the alk-phos and Gamma GT went up to about 600 and 900 respectively, and is still relatively constant at these values after almost a year. My doctors are not too much worried about these levels, as long as it doesn’ t increase and the bilirubin levels stay normal. I’ m going for checkups bi-annually.
Subsequently I developed diabetes and malabsorption due to pancreatic insufficiency. From oral diabetic medication in 2009 to insulin in 2011 and ever since. Currently using Creon for pancreatic insufficiency.
I’ m not using any alcohol since XXXXXXX 2007, is more active and eat much healthier. I’ m a bit worried though about the high ALP and GGT levels, with ALP about 350 and GGT 1500. My physician not too concerned since Bilirubin levels normal and no physical signs of pain and discomfort.
Does the constant high ALP and GGT levels imply residual liver damage or could this be related to blocked bile duct?
Before the biliary bypass, my bilirubin levels was abnormally high, Alk-Phos and Gamma GT in the region of 200 – 300. After the biliary bypass surgery, my bilirubin came down and within 3 months it was normal again. Just after the bypass surgery, the alk-phos and Gamma GT went up to about 600 and 900 respectively, and is still relatively constant at these values after almost a year. My doctors are not too much worried about these levels, as long as it doesn’ t increase and the bilirubin levels stay normal. I’ m going for checkups bi-annually.
Subsequently I developed diabetes and malabsorption due to pancreatic insufficiency. From oral diabetic medication in 2009 to insulin in 2011 and ever since. Currently using Creon for pancreatic insufficiency.
I’ m not using any alcohol since XXXXXXX 2007, is more active and eat much healthier. I’ m a bit worried though about the high ALP and GGT levels, with ALP about 350 and GGT 1500. My physician not too concerned since Bilirubin levels normal and no physical signs of pain and discomfort.
Does the constant high ALP and GGT levels imply residual liver damage or could this be related to blocked bile duct?
Brief Answer:
AST and ALT enzymes should be elevated in case of liver issue.
Detailed Answer:
Hello!
Thank you for the query.
After bile ducts bypass surgery there is still risk to have this junction (between the small intestine and main bile duct) can get narrow after some time. This can lead to jaundice recurrence. However you should have dark urine, pale stool, itchy skin and high bilirubin levels. If no signs of jaundice, the junction works just fine.
What are the liver enzymes (AST and ALT)? GGTP and ALP can be elevated due to for example liver viral infection. You could get this from the hospital (ICU stay makes the risk higher). Viral liver infection should cause also elevated AST and ALT along with GGTP and ALP elevation.
Hope this will help. Feel free to ask further questions.
Regards.
AST and ALT enzymes should be elevated in case of liver issue.
Detailed Answer:
Hello!
Thank you for the query.
After bile ducts bypass surgery there is still risk to have this junction (between the small intestine and main bile duct) can get narrow after some time. This can lead to jaundice recurrence. However you should have dark urine, pale stool, itchy skin and high bilirubin levels. If no signs of jaundice, the junction works just fine.
What are the liver enzymes (AST and ALT)? GGTP and ALP can be elevated due to for example liver viral infection. You could get this from the hospital (ICU stay makes the risk higher). Viral liver infection should cause also elevated AST and ALT along with GGTP and ALP elevation.
Hope this will help. Feel free to ask further questions.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
AST was 69, don't have ALT result
Brief Answer:
Abdominal CT would be a good idea.
Detailed Answer:
Than this is not a liver disease. This is rather due to chronic pancreatitis.
As this enzymes can get elevated due to a cancer as well, it would be a good idea to have abdominal CT done.
Abdominal CT would be a good idea.
Detailed Answer:
Than this is not a liver disease. This is rather due to chronic pancreatitis.
As this enzymes can get elevated due to a cancer as well, it would be a good idea to have abdominal CT done.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Raised ALP even after biliary bypass? I see I omitted to mention cholesystectomy before biliary bypass.
Brief Answer:
Cholecystectomy is always done with this procedure.
Detailed Answer:
Cholecystectomy is always the first step of this procedure. So no need to mention it. And it does not change anything.
ALP is just an enzyme. It gets elevated in case of many different situations. Bile ducts obstruction is one of them. But not the only one. Pancreas inflammation gives elevated ALP as well. It may be chronic at your case.
For sure there is bile ducts obstruction present. Just the bile bypasses this area. So the bile is not high and ALP can be high.
In my opinion, you should have abdominal CT done. If everything will be fine in this test, we have to assume that high ALP is due to bile ducts obstruction even with fine working bypass.
Cholecystectomy is always done with this procedure.
Detailed Answer:
Cholecystectomy is always the first step of this procedure. So no need to mention it. And it does not change anything.
ALP is just an enzyme. It gets elevated in case of many different situations. Bile ducts obstruction is one of them. But not the only one. Pancreas inflammation gives elevated ALP as well. It may be chronic at your case.
For sure there is bile ducts obstruction present. Just the bile bypasses this area. So the bile is not high and ALP can be high.
In my opinion, you should have abdominal CT done. If everything will be fine in this test, we have to assume that high ALP is due to bile ducts obstruction even with fine working bypass.
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
