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Suggest Treatment For Inflammatory Bowel Disease

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Posted on Thu, 18 Aug 2016
Question: 27 y/o male registered nurse with Crohn's disease dx in 2013. Take Mesalamine, Welbutrin, Celexa daily and Prilosec every night before bed. I drink one alcoholic beverage maybe once a month. My AST was 46 and ALT was 98 on a recent lab draw. The week before the lab draw I stopped Welbutrin and Celexa for about 4 days before restarting them the weekend before the draw. My stools usually vary in color and form while leaving more to being loose. Occasionally, they're yellowish in color. My GI doc ordered hep screens which already came back negative and an U/S later this week. He said no lab redraw was needed, which I found unusual. I'm very nervous something bad is going to show on imaging.
doctor
Answered by Dr. Dr.P.Ratnakar Kini (9 hours later)
Brief Answer:
PSC, AIH?

Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.

The raised liver enzymes is less likely to be due to drinking alcohol.
You are diagnosed with inflammatory bowel disease (Crohn's disease). IBD is sometimes associated with primary sclerosing cholangitis (PSC) and autoimmune hepatitis (AIH). Though ulcerative colitis is more commonly associated with these two, sometimes it can occur in those with Crohn's disease also. These two can elevate liver enzymes.

Discuss with your doctor about these possibilities.
We also wait for the US scan report.

Regards,
Dr.R.K
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Dr.P.Ratnakar Kini (15 hours later)
Ok thanks. Are those numbers considered to be very elevated or concerning? My GI doctor seemed upset by them, but my PCM didnt seem concerned and even stated they didnt typically do anything about it unless they were at least double my numbers.
doctor
Answered by Dr. Dr.P.Ratnakar Kini (9 hours later)
Brief Answer:
ALT appears significantly elevated

Detailed Answer:
Hi,
Yes, we consider it significant if it is elevated more than twice the upper limit of normal.
Your ALT is more than twice the upper limit of normal and is significant.

Regards,
Dr.R.K
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr.P.Ratnakar Kini

Gastroenterologist

Practicing since :1994

Answered : 2215 Questions

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Suggest Treatment For Inflammatory Bowel Disease

Brief Answer: PSC, AIH? Detailed Answer: Hi, Thanks for posting your query. I am Dr.R.K and I am pleased to assist you. The raised liver enzymes is less likely to be due to drinking alcohol. You are diagnosed with inflammatory bowel disease (Crohn's disease). IBD is sometimes associated with primary sclerosing cholangitis (PSC) and autoimmune hepatitis (AIH). Though ulcerative colitis is more commonly associated with these two, sometimes it can occur in those with Crohn's disease also. These two can elevate liver enzymes. Discuss with your doctor about these possibilities. We also wait for the US scan report. Regards, Dr.R.K