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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for elevated liver enzymes

Answered by
Dr.
Dr. Sunil

Gastroenterologist

Practicing since :1982

Answered : 351 Questions

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Posted on Fri, 9 Jun 2017 in Digestion and Bowels
Question: Dr., I have been diagnosed with stetohypetitis in January 2016 (F1-F2, A1-A2). Early sign was elevated liver enzymes. Part of the problem was traced to taking 40 mg of simvastatin for cholesterol, which was more than I needed because cholesterol well under control. (Dr. raised it to 40 mg solely because it was "recommended".) After I went back to 20 mg of statin, liver enzymes returned to normal. The doctor also put me on vitamin E, 400 mg. Last fibrosure test in January 2017 showed activity stage down to A0-A1. I praise the Lord for that. Two questions: Is there a chance that the progression of this liver problem can be reversed? Also, I was prescribed omeprazole 40 mg for acid reflux, but side effects literature says, "very bad pancreas, liver and white blood cell problems have happened in people taking this medication." Also, online website raises caution in using omeprazole for people with "liver disease". Will omeperzale make my liver condition worse (raise liver enzymes, fibrosure results, etc.)? Would substituting omeperzale with ranitidine be better? Please advise and many thanks. --XXXX
doctor
Answered by Dr. Sunil 2 hours later
Brief Answer:
Proton pump inhibitor is one of the safest class of drugs.

Detailed Answer:
Hello,
Thanks for posting the query on this forum.

As per your concerns answers are-

1) Statin-induced hepatotoxicity is fully reversible and all the liver enzymes should return back to normal within 6-8 weeks.

2) Theoretically cases of acute liver failure due to proton pump inhibitors have been described, but they are exceedingly rare.Proton pump inhibitor is one of the safest medicines used ever. Don't worry, too much googling can only cause unnecessary worries. Hepatotoxic effect of proton pump inhibitor is something very very rarely encountered in clinical practice.

Ranitidine is an H2 blocker but effectivity in treating Reflux of acid is far less as compared to omeprazole, Frankly speaking, I don't think omeprazole 40 mg once daily is going to do any harm to you. However, in case you want to follow the theory, you can switch over to Ranitidine 150 mg twice a day. It's safer but less effective compared to proton pump inhibitors.

Follow ups are most welcome.
Warm Regards.
Thanks.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
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