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    What causes lower abdominal pain despite having normal LFT report?

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Posted on Fri, 3 Jun 2016 in Medicines and Side Effects
Question: Hi,

My cholestral was elevated in December 2015 and I went back last week for repeat bloods and cholestral was normal level again but my ALT was 110 and all other liver readings were fine. I have pain in my lower abdomen which I said to the doctor and she is having a new liver blood test in one weeks time, I have been taking protium for a ulcer that has now healed. Should I be concerned ?
doctor
Answered by Dr. Panagiotis Zografakis 1 hour later
Brief Answer:
yes...

Detailed Answer:
Hello,

you haven't mentioned a statin, so I gather that you don't take any. Cholesterol is not related to the high ALT value. The pain in lower abdomen does not seem relevant as well.

A high ALT value is usually caused by fatty liver, which is more common in obese patients or patients with diabetes or high alcohol consumption.
Other potential causes include drugs (almost any drug), toxins, infections (mostly viral, like hepatitis), autoimmune conditions (like autoimmune hepatitis), tumors, heart failure, etc.

Since you're young and you haven't mentioned any medical history then I suppose that this has to be either toxic in etiology (a toxin or drug) or infectious. The repeat tests are important to get a good idea of what is going on. Serologic tests for infectious and autoimmune hepatitis would be very helpful! ANA, SMA, Anti-LKM1 and also antibodies for HCV, serology for HBV, EBV, CMV, etc. A liver ultrasound scan will also help.

Liver injury (implied by the high ALT value) is worrisome and has to be clarified regarding its etiology.

KInd Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis 6 minutes later
When i had ulcer i was also given triple therapy which included two antibiotics which lasted two weeks and finished in 2nd week of january but have remained on stomach protector called protium so maybe this has caused it. Would this be serious and is there anything i can do to being levels down
doctor
Answered by Dr. Panagiotis Zografakis 7 minutes later
Brief Answer:
0.4% of patients may experience high ALT with pantoprazole

Detailed Answer:
It is possible. Up to 0.4% of patients taking pantoprazole may have high ALT (more than three times the upper normal limit). Please understand though, that there is no way to document it, unless you exclude all other potential causes. Thus repeat and further testing is required to clarify this issue.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis 4 minutes later
Thanks for your replys you have been very helpful, its seem unlikely its from protium so and must be something else underlying which hopefully they will find. Thanks for your time
doctor
Answered by Dr. Panagiotis Zografakis 5 minutes later
Brief Answer:
do not underestimate this 0.4%

Detailed Answer:
You're welcome!

Do not underestimate 0.4%. This percentage refers to patients with high elevations of ALT (more than 3 times the upper normal limit). Lower elevations may occur in other patients (a small but significant percentage). If no other explanation can be found then it has to be pantoprazole...

Best wishes for a speedy recovery!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis 29 minutes later
Thanks a mill you have been a great help
doctor
Answered by Dr. Panagiotis Zografakis 14 minutes later
Brief Answer:
You're welcome!

Detailed Answer:
You're welcome!

Glad to help!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3694 Questions

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