Question: Hi
I have a long history of elevated Gamma GT (normally stable around 90U/l), following a severe reaction to the drug Lamisil. When affected 20 years ago it was then over 250. Suddenly, 3 months ago, it XXXXXXX to 198 and has remained around 150 since. I have been getting a dull pain on right side of my abdomen just below my rib cage for around a year or so and more recently I am getting itchy skin around the area of the base of my spine. I drink moderately around 10 units a week (well below the recommended maximum) and have done so at this level following the Lamisil reaction. (I gave up alcohol completely for 2 years after the Lamisil incident but it appears my 'normal' Gamma GT level does not alter whether I drink 10 units or zero.) 2 weeks ago, I had an ultrasound scan that did not show up anything unusual, except my liver and gallbladder are funny shapes! Sorry this is not more helpful but that's what's in the radiologist's notes. (An ultrasound scan 7 years ago revealed fatty deposits and crystals at the lower end of my gall bladder.) My doctor is not concerned and says I shouldn't be either. But I am ... should I be?
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(p.s. I live in the UK)

Dear Dr. Klerida
Thank you for your reply. Unfortunately, the notes from the recent ultrasound investigation are in my computerised medical records to which I have no access. I am currently being treated under the UK National Health Service, not as a private patient. However, your preliminary conclusions make sense.

I don’t smoke so that would not be a cause, but I do occasionally enjoy a drink and I can tell that the dull pain I referred in my first message is sometimes more noticeable after certain types of alcohol, for example red wine. I generally try to watch what I eat and drink quite carefully and consider I have a reasonably healthy diet. I am 6 ft 4 ins tall and 200 lbs. I don’t have an excessively fatty diet and I would say that my alcohol consumption is only half that the recommended maximum. Having said that and just to contradict myself, I had steak and fries for dinner on Monday together with one and half glasses of red wind but didn’t feel a thing afterwards. Maybe one of my next avenues of investigation should be food intolerance and I might try allergy testing to foodstuffs I consume a lot such as bread and coffee.

Yesterday I went for a chest x-ray as part of the ongoing investigations and I will have another liver function blood test in a couple of weeks. I will then go to see my doctor again at the end of the month when the results have been sent to him and if nothing conclusive comes to light, I think I will request to be referred to a gastroenterologist.

As a postscript, I remember some 14 years ago after living in Germany for a while, I started to get similar but more pronounced abdominal pains. At that time I don’t remember having a liver function test so I have no idea what my Gamma GT level was. A gastro endoscopy showed inflammation in the upper intestine and I suspected this could be related to the high quantities of industrial strength coffee I was drinking. I cut out the coffee and the pains subsided. I wonder if this could be a reoccurring problem but not on quite an acute level. It would be interesting to know if there any evidence of a correlation between raised Gamma GT and inflammation of the upper intestine, as there is with gall bladder issues.

Regards
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