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Dr. Andrew Rynne

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Have IBS. Test showed ast 52 and alt 40 . How to get cured?

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Dr. Raju A.T

General & Family Physician

Practicing since :2008

Answered : 3866 Questions

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Posted on Sat, 15 Dec 2012 in IBS(Irritable Bowel Syndrome)
Question: my ast is 52 and alt is 40 I
I've had upper right abdominal pain, bloating, nausea,increased burping.
I'm told I have IBS.
Gall bladder was removed in 1998
MI in 1991 at which time I quit smoking, developed PAD and had surgery on the femoral artery in 2010.
First time plaque was removed, developed a clot a couple days later and had bypass on the same artery with a stent. Was doing well but then developed stenosis 6 weeks later.Unable to remove blockage in the stent.
doctor
Answered by Dr. Raju A.T 5 hours later
Hi,

Thanks for your query.

The levels of AST and ALT you mentioned though slightly out of range are not significant to indicate serious trouble. Such readings can be seen in normal healthy people too.

Upper right abdominal pain and other symptoms you have could be seen in gall bladder pathology, IBS or acid peptic disease. Since the gall bladder is removed long back, either IBS or Acid peptic disease to be the cause for the symptoms you have.

Do take Tab Prilosec OTC once in morning before breakfast for a minimum of a week. This will reduce the basal acid output and reduce acidity and thus the symptoms.

PAD (Peripheral artery disease) seems well managed by surgery. Either the PAD or the surgery is related to the current episode.

I would like to know some more history on the CAD (Coronary artery disease) and present status to comment on it better.

Was an angioplasty performed in last 6 weeks? If yes, what was the report?
Did you consult your Cardiac surgeon? If yes, what is the plan of management?
Do you have any concerns in this regard where I could be of help?

Waiting for your response,

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Raju A.T 8 hours later
Thank you for your reply. As far as the CAD, no there has been no surgery at all. My blockage at the time of the MI was 70% in the right coronary artery. IT is now 100% occluded but enough collateral circulation has developed that my cardiologist is satisfied that diet, exercise and medication is keeping things stable. I've had no other episodes since the MI. I take toporol and altace for BP along with crestor.
If I could go back to the PAD for your opinion. I've wondering if anything can be done with the 100% occluded stent? Although it's been over 2 years since the surgery has there been any new procedures that address this issue? I go for an ultrasound every 6 mos. which shows no change except the doctor said circulation has improved from .6 to .7. I'm not sure exactly what it means other than my foot longer feels cold and I do detect some pulses. However, I still experience more pain walking than I would like. I can force myself to walk a mile on the treadmill in under 19 minutes. I would appreciate your input as to any options that can improve my situation. Thanks again
doctor
Answered by Dr. Raju A.T 15 hours later
Hi,

Thanks for writing back.

If it is the stent in coronary artery you are referring to be blocked 100%, I agree with your cardiologist. It would be better not to disturb it as are good collateral circulation.

There has been not much improvement in the field of PAD (Peripheral artery disease) management. Angioplasty/stent procedure, bypass surgery, arterectomy, thrombectomy (plaque excision), etc., have been tried as a treatment since sometime. Of these angioplasty is favoured for its minimal complication, easy approach and limited restrictions. However stent stenosis is occurs commonly and can be rectified by restenting. But it looks like you are doing well and the limb circulation is improving. In such cases, it would be best to leave the decision of revision surgery to your current surgeon.
It is essential to monitor the blood flow in the arteries regularly and at any point of time if the circulation is found to be impaired, then a revision surgery would be necessary.
Good exercise and anticoagulant therapy would be sufficient till then.

Hope I answered your query. Let me know if you need further assistance.
If all your queries are answered, please close this discussion.

Wish you good health.

Regards,

Above answer was peer-reviewed by : Dr. Prasad
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