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    What causes chronic elevated liver enzyme levels and lack of appetite?

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Posted on Thu, 29 Jun 2017 in Liver and Gall Bladder
Question: My oncologist says i have chronic elevated liver enzymes and i should see my regular doctor. My regular doctor sent me for a ultrasound which came back with issue that they had me do MRI and showed cyst that they want me to be tested again in 3-6 months. Had colon cancer May 2016. My alkaline phosphatase is 144 and my ALT is 69 but my AST is normal 35 on this blood test. What is your recommendation as I only had a CT Scan of my lungs and MRI of my liver. Oncologist cancelled my CT scan with contrast as I had some breathing issues that I had the CT Scan. I feel like that I did not have a thorough CT Scan to check for cancer. I have not gained my energy back, lack of appetite, and have a low grade pain in the area where my colon was removed. I am sure the neuropathy which is so debilitating is not helping me to get better. Finished chemo in January 2017. My oncologist does not seem concerned as I feel she is not taking this seriously.
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Answered by Dr. Ramesh Kumar 29 minutes later
Brief Answer:
PET scan should be done.

Detailed Answer:
Hello Dear patient,
Thanks for choosing HealthcareMagic for your query.
O am a Gastroenterologist and would be answering your query.

As per your query answers are-
1) I feel like that I did not have a thorough CT Scan to check for cancer. - See ideally a PET scan should be done.Positron Emission Tomography (PET) imaging have become essential diagnostic tools physicians use to reveal the presence and severity and nature of cancer of cancers.You are recent case of colon carcinoma and now a cyst has been detected in your liver.Its more advisable to get a PET scan done(to make sure that its not a metastatic mass rather waiting and watching for 6 months).When we have facilities and technology there is no sense of taking risk(even if its 0.1%) or having a wait and watch policy. As per text book protocol a PET scan should be done.
CT is initial scanning test and sensitivity to rule out small metastatic lesions is very low.
2)I have not gained my energy back, lack of appetite, and have a low grade pain in the area where my colon was removed.-They are most likely the side effect of cycles of chemotherapy you were on.However for symptomatic relief include enzyme supplements and probiotic in your diet along with a quality anti oxidant.In long term they will increase your energy levels and would help to maintain overall health.Take a proton pump inhibitor daily for few months like omeprazole(OTC)


Strong recommendation-
PET scan should be done asap and wait and watch is not a good policy.Even if you are allergic to a particular contrast medium there other options available.Your oncologist should take things seriously.
Feel free to follow up.
Thanks.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2425 Questions

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