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Have indigestion. Drink and smoke. Elevated SGOT and SGPT. Prescribed ursodeoxycholic and evion. Suggest?

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Dermatologist
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Hi. i am 26 years old. i have an indigestion problem. i drink 5 to 6 times a month. i smoke also. i have my liver test. my sgot came as 89 and sgpt as 189. now i have left every thing. taking only boil food. my weight is 89 kg. i am regularly doing morning walk from last few days. AFTER 20 DAYS WHEN I AGAIN CHECKED MY SGPT AND SGOT LEVEL IT INCREASES. PLEASE SUGGEST ME WHAT TO DO? AT PRESENT SGOT IS104 AND SGPT IS 229. NOW DR HAS PRESCRIBED BE URSODEOXYCHOLIC ACID TAB TWICE DAILY ALOND WITH EVION 400 AND PRE-PRO BIOTIC TABS ONCE DAILY. PLEASE SUGGEST ME WHAT TO DO? I AM CONTINUING ME EXERCISE REGULARLY????/
Posted Mon, 1 Jul 2013 in Liver and Gall Bladder
 
 
Answered by Dr. Johny Chacko 54 minutes later
Hello XXXXXX
Welcome to healthcare magic
I want to know when did you first check your liver enzymes ?
What was the indication for checking liver function and do you have the entire liver function test report , and not just sgot and sgpt ?
5 to 6 times drinking usually do not cause such elevation of liver enzymes. Do you binge on alcohol when you drink or in moderation.
Did you have jaundice in the past ?
Kindly get back to me with the above details so that I can answer your query better.
Take care
Above answer was peer-reviewed by
 
Follow-up: Have indigestion. Drink and smoke. Elevated SGOT and SGPT. Prescribed ursodeoxycholic and evion. Suggest? 51 minutes later
I HAVE BEEN SUFFERING FROM LOOSE MOTION. TWO DAYS I FEEL BETTER THAN NEXT DAY AGAIN LOOSE MOTION. THEN I WENT FOR LIVER ENZYME TEST. I DID MY FIRST TEST ON 11.5.13. THERE MY SGOT CAME AS 89 AND SGPT AS 189. ALKALINE AS 246 AND LACTATE DEHYDROGENESE AS 253. THEN I CONSULT DOCTOR. HE SUGGESTED ME TO STOP DRINKING IMMEDIATELY, TO STOP SMOKING AND TO DO REGULAR EXERCISE. I FOLLOWED HIS ADVICE. I INFACT TOOK BOIL FOOD TILL 20 DAYS. DID REGULAR EXERCISE. HE ALSO SUGGESTED ME FOR FASTING GLUCOSE TEST,LIPID PROFILE TEST AND WHOLE ABDOMEN ULTRASONOGRAPHY. AND PRESCRIBED ME RIFIXIMIN TAB 2 TABS DAILY, EVION 400 2 TABS DAILY AND RABEPRAZOL 20 FOR 2 WEEKS. AFTER 20 DAYS I DID ALL MY TEST WHICH CAME AS NORMAL. ONLY ONE THING CAME IS THAT IN ULTRASOUND IT SEEMS MY PANCREAS MILD FATTY. AND SGOT CAME AS 104 AND SGPT AS 229. I WAS VERY MUCH SCARED. DOCTOR THEN GAVE ME URSODEOXYCHOLIC ACID 300 TWO TIMES A DAY,WITH PRE AND PROBIOTIC CAPSULES ONCE DAILY AND EVION 400 TWICE DAILY. AND HE ALSO GIVEN ME THE FOLLOWING TEST WHICH I DID YESTERDAY AND REPORT DID NOT CAME TILL NOW. CERULOPLASMIN,TSH AND XXXXXXX ELISA. I AM VERY MUCH SCARED. PLEASE SUGGEST ME WHAT TO DO???
 
 
Answered by Dr. Johny Chacko 2 hours later
Hello XXXXXX
Welcome back.
What was the level of your direct bilirubin and indirect bilirubin and total bilirubin ?
Abominal scan showed fatty liver or fatty pancreas ?
Did it show any gall bladder stones ?
Mild elevations of liver enzymes can even be caused by rifaximin. Stop Rifaximin.
Did you do hepatitis profile to rule out Hepatitis A, B, C, D, E?

You have a feature to upload the images of reports by yourself at the right side of the query page, please utilize that so that I can answer your query better. You can also send the image as attachment to YYYY@YYYY , with the subject as 'Attn: Dr. Johny Chacko'.

Please give me the following details. I don't think you should be scared as these enzymes are not very high.
Waiting to hear from you.
Take care
Above answer was peer-reviewed by
 
Follow-up: Have indigestion. Drink and smoke. Elevated SGOT and SGPT. Prescribed ursodeoxycholic and evion. Suggest? 2 hours later
My ultrasound results shows a milf fatty pancreas. Bilirubin is normal. No sonography. No hepatitis detected. Sir as you told earlier that rifiximin rise enzyme level but sir i took rifiximin 10 days earlier than the second sgpt and sgot test. Sir please help me what to do.
Thank you
 
 
Answered by Dr. Johny Chacko 39 minutes later
Hello XXXXXX
Fatty pancreas can be due to obesity, fatty diet and alcohol intake.
You should decrease your weight , should never take alcohol and reduce oily and fatty foods. Fatty pancreas can cause loose motions and indigestion.

Fatty pancreas is usually associated with fatty liver as well. Fatty liver can raise liver enzymes. As your bilirubin is normal it is not jaundice. Rifaximin can raise the liver enzymes. Even after 10 days of stopping it can still be high, might be falling and eventually will slowly come down.
It is better to rule out hepatitis A,B,C, E by doing viral markers to rule out any occult viral infections.
Your doctor is right in doing XXXXXXX and ceruloplasmin as lupus and wilson's disease can also cause fatty pancreas and elevated liver enzymes.
There is no emergency and you are on the right track.
Hope I have answered your query.
Take care
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