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Heavy drinking, blood work, AST, ALT, normal hep screen, liver ultrasound. Damage to liver due to drinking or gall bladder ejection ?

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Gastroenterologist, Surgical
Practicing since : 2006
Answered : 38 Questions
My bloodwork 6 mths. ago was ast of 47 and alt of 69 with normal hep screen and normal liver/gallbladder ultrasound. My ast now is 44 and alt 65. My hyda scan said 9% ejection fraction of gallbladder. I drank heavily for 18 months prior first bloodwork, but have stopped now. Could I have liver damage from drinking causing this or is it unrelated to gallbladder ejection? Is the gallbladder probably causing the elevated enzymes and should be removed?
Posted Sun, 29 Apr 2012 in Liver and Gall Bladder
Answered by Dr. Tapan Shah 11 hours later
Thanks for the query.

Lets come down straight to the point, well your queries were very vague actually but stilll let me try to answer each question and then help you out with it completely.

q.1 Have you damaged your liver with drinking? YES

Q.2 Is it related to gallbladder ejection? NO BUT MAY BE

Q.3 Is the gall bladder causing elevated enzymes? NO but Gall Bladder stone or calculi might.

Now lets go into a bit more detail, due to alcoholic habit, yes there would be certain damage to your liver. I can't be sure, from distance if those changes are reversible or irreversible. But as you reported your ultrasound were normal ( that means i presume there is no changes in liver ecotexure i.e the surface; if there is irregularity, if any enlargement)

Considering this fact that your ultrasounds are normal, we consider the raised in enzymes due to gall stone or calculi, when they pass through bile duct. So when you get a Ultrasound done, the stone either is not visible ( due to calculi) or passed away in to the tract.This could be the because of raised AST / ALT(aspartate aminotransferase/alanine aminotransferase).

Now as your Gall Bladder ejection fraction is on 9%, that indicates chronic variety of cholecystitis. and that could be the cause of raised enzymes and poor ejection fraction.

Now regarding your last question ,internationally it is recommended for you to have gall bladder removed but only when all other causes of raised AST/ ALT are been ruled out.

Hope i have answered your query.Please proceed with the query.
Above answer was peer-reviewed by
Follow-up: Heavy drinking, blood work, AST, ALT, normal hep screen, liver ultrasound. Damage to liver due to drinking or gall bladder ejection ? 1 hour later
So if the ultrasound of liver and gallbladder normal, which showed no stones also, and the hyde scan showed no obstruction of ducts, the ejection fraction being low can cause elevated ast and alt. If yes it can, please tell me how does this.
Answered by Dr. Tapan Shah 3 hours later

Thanks for writing again.

When the gall bladder is not ejecting enough, there is likelyhood that the gall bladder is now fibrosed (the wall are not able to contract as good as it used to). Fibrosis could be due to recurrent inflammation occuring in gall bladder. This recurrence and long standing inflammation is termed as Chronic Cholecystitis.

The low ejection per say doesn't raise the enzymes but the raised AST/ALT could be due to subclinical alcoholic hepatitis or due to small calculi or sludge being formed in gall bladder. When such calculi passes the bile duct leads to biliary colic and inflammation leading into raise AST/ALT.

I hope, I have answered your query.

Wish you good health.

Above answer was peer-reviewed by
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