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What Does Blood Alkaline Phosphatase Level 150 Indicate?

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Posted on Mon, 28 Dec 2015
Question: Recent blood tests, CBC, Comp Metabolic Panel, lipid panel. All tests were normal except for Alkaline Phosphataase was 150.. I had my gallbladder removed in October of this year. Had a CT scan while in the hospital and it said possible mild colitis. I have been experiencing weakness, uneasy stomach and some light diarrhea. What could the 150 ALP mean? AST was 17 and ALT was 26, bilirubin was 0.3.
doctor
Answered by Dr. Muhammad Hanif (5 hours later)
Brief Answer:
This is not such a high value for ALP to get scared in the first place.

Detailed Answer:
Thanks for consulting me at virtual clinic. Your trust in HCM means a lot to me as a Physician.
I have completely reviewed your health query, and can well realize all those concerns. Being your physician, I will take care all of them today and will give extend my expertise to solve the problems.

The normal levels for ALP may range between 45-148 IU/L. Normal values may vary from laboratory to laboratory. Your values for ALP are not that much high to cause a medical concern needing immediate intervention. But this test will serve as a baseline for future comparison to see if the levels come down or go up.

At this age your blood work is extraordinary and you are doing good. Slight biliary obstruction, bone disease or inflammation of liver may sometimes cause a bit change in ALP levels. But if the Levels go up many folds the normal limits then it is a sign of concern.

Weakness, dizziness, uneasy stomach, and mild diarrhea are all natural after having gall bladder removed. Try less fats in diet, more of vegetables, fruits and salads. Keep Citrucel Dietary Fiber supplement in diet. Take plenty of water and try to remain physically active as much as you easily can.

For future:-
You need to repeat the same test after 6-8 weeks for comparison with these results.

Hope I answered all of your queries. Let me know if you have further clinical concerns or doubts. I will be more than happy to get back to you with my expert opinion. Please don't forget to give Five Star rating to help me assist patients in a better way; and, please don't forget to 'Close This Discussion'.
For any disease you have, a timely follow-up is very necessary regarding the treatment efficacy and to see if there is a need to change the treatment options. So keep a follow up to see how you doing (Always write down my name in start of your questions at this forum & I will be with you in no time).


Regards!
DR. HANIF
USA
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Muhammad Hanif (12 hours later)
My surgery was October 13, 2015. I felt better but then started feeling bad, again. The weakness does worry me. I feel like I have something at the end of my anus, maybe a hemmoroid...do not know. Could that be colitis? How do I treat at home mild colitis? Also on my ct scan, it said "No free air. Aortoiliac atherosclerotic disease without aneurysm. No
abdominal wall hernia. No pathologic adenopathy on the basis of CT
size criteria." I asked my Doctor and she wasn't concerned, not at all. Said everyone has that, at some point. Should I see a different Doctor? Like I said, other blood tests were in limits.
doctor
Answered by Dr. Muhammad Hanif (11 hours later)
Brief Answer:
It may be hemorrhoids at the end of anus. Consult a Gastroenterologist!

Detailed Answer:
Welcome back and thanks for putting up a follow up query. I am happy to assist you for the same.

Weakness is very usual and is common after Cholecystectomy and you are having the same. On your CT Scan they found mild colitis too. It all makes the nutrient absorption and assimilation a bit lower than optimal and causes weakness. But keeping a balanced and healthy diet helps get better results even after this surgery.

The lesion that is felt at the end of anus is not colitis. It most probably is due to Piles (hemorrhoids). Colon ends far inside. After that comes the rectum and then the anus. Colitis can't be felt by the patient.

Colitis needs antibiotics (Bactrim DS) and high fiber diet with plenty of water. We use Mesalamine for inflammation caused to the colon due to disease. If diarrhea (most of the patients have that) we add Loperamide. Take Citrucel dietary fiber supplement with plenty of water.

No pathologic adenopathy is good news. You may consult a Gastroenterologist for more evaluation who will go for Colonoscopy and will rule out hemorrhoids, colitis and other issues if any.

Hope I answered all of your queries. Let me know if you have further clinical concerns or doubts. I will be more than happy to get back to you with my expert opinion. Please don't forget to give Five Star rating to help me assist patients in a better way; and, please don't forget to 'Close This Discussion'.
For any disease you have, a timely follow-up is very necessary regarding the treatment efficacy and to see if there is a need to change the treatment options. So keep a follow up to see how you doing (Always write down my name in start of your questions at this forum & I will be with you in no time).


Regards!
DR. HANIF
USA

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Muhammad Hanif (17 hours later)
what about: "No free air. Aortoiliac atherosclerotic disease without aneurysm. No
abdominal wall hernia. No pathologic adenopathy on the basis of CT
size criteria." My primary Doctor doesn't seem concerned. I do feel pressure in the rectum area. My surgery was Lapo.
doctor
Answered by Dr. Muhammad Hanif (5 hours later)
Brief Answer:
Gastroenterologist consultation and investigations are inevitable!

Detailed Answer:
Welcome back and thanks for a follow up query. I am here to happily assist you and will answer all the doubts you have. I have answered your queries in the order they are raised by you.

Free air:
When there is some perforation anywhere in the intestine, air leaks out and causes free air on imaging investigations. That is a sign of some serious disease of intestines. There is no free air means no intestinal perforation.

Aortoiliac Atherosclerotic disease:
means iliac blood vessels that supplies the legs and structures below, and the abdominal aorta has some atherosclerotic disease changes in the arterial lumen. May be stiffness, or other atheromatous changes.
Why these changes happen? This may be age related, due to high blood pressure, due to deranged lipid profile, smoking and alcohol induced etc.

Without aneurysm?
Aneurysm means abnormal dilatation of the vessel lumen due to disease of the blood vessel. You don’t have that.

Abdominal wall hernia?
It is due to the abnormal bulging outpouching of the intestinal contents through a non natural pathologic orifice/opening. e.g. umbilical or paraumbilical hernia, Inguinal hernia etc.

No pathologic adenopathy means there is no lymphatic system disease. As, happens in cancers that metastatic cancers involve the abdominal lymph nodes.
The pressure in the rectum area may be due to hemorrhoids or other rectal/anal problems. You need to consult a Gastroenterologist who will definitely go for Proctoscopy/Colonoscopy for definitive diagnosis of the cause for the same.


Hope I answered all of your queries. Let me know if you have further clinical concerns or doubts. I will be more than happy to get back to you with my expert opinion. Please don't forget to rate to help me assist patients in a better way; and, please don't forget to 'Close This Discussion'.
For any disease you have, a timely follow-up is very necessary regarding the treatment efficacy and to see if there is a need to change the treatment options. So keep a follow up to see how you doing (Always write down my name in start of your questions at this forum & I will be with you in no time).


Regards!
DR. HANIF
USA
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Muhammad Hanif (16 hours later)
1. CT scan said: QUESTION OF MILD COLITIS, POSSIBLY SECONDARY. Secondary to what?
2. Does colitis need to be treated or does it go into remission.
3. Should I be concerned regarding the Aortoiliac Atherosclerotic disease? The surgeon never mentioned any concerns. Said I did great during the Lapo surgery and I was basically in good health.
4. Said heart was normal size.
5. The 150 ALP blood test, could this be related to colitis?
6. I do not have blood in bowel movements, no stomach pain, basically all I have is a little nausea in the morning, weakness and fatigue, some loose bowels. Concerns? I will paste the CT results:
FINDINGS:

Normal heart size. Minimal atelectasis in the dependent lung bases. No
effusions.

Normal appearance of the liver, spleen with adjacent splenule, and
adrenal glands.

Mildly dilated gallbladder measuring 8.7 cm in long axis. Minimal
prominence of the bile ducts. No intraluminal filling defects.

Mild to moderate diffuse edema of the pancreas with surrounding fluid
and stranding. No focal fluid collections.

Tiny bilateral renal cortical low attenuation lesions, too small to
characterize but most likely cysts. No acute genitourinary pathology.

Postsurgical absence of the uterus. Nonidentified ovaries.

Unremarkable noncontrast evaluation of the stomach and small bowel.
Normal appendix.

Normal caliber colon. Mildly prominent appearance of the walls of the
mid transverse colon through the descending colon, with part of the
splenic flexure coursing near the peripancreatic inflammation. No
adjacent inflammation elsewhere.

No free air. Aortoiliac atherosclerotic disease without aneurysm. No
abdominal wall hernia. No pathologic adenopathy on the basis of CT
size criteria.

Mild scoliosis. Prominent L5-S1 degenerative disc disease. Less
pronounced degenerative changes at other levels. No acute or
suspicious osseous abnormalities.

IMPRESSION:
1. ACUTE PANCREATITIS. NO ORGANIZED FLUID COLLECTIONS.
2. MILDLY DILATED GALLBLADDER WITH MINIMAL PROMINENCE OF THE BILE
DUCTS. NO IDENTIFIED FILLING DEFECTS.
3. QUESTION OF MILD COLITIS, POSSIBLY SECONDARY.
4. POST HYSTERECTOMY.
Impressions? What should I be concerned about?
Also, can I take Cipro and Ibuprofen? Cipro was for a possible sinus infection. Don't want to upset my stomach.
doctor
Answered by Dr. Muhammad Hanif (6 hours later)
Brief Answer:
You can't take Ciprofloxacin without first consulting a Gastroenterologist!

Detailed Answer:
Welcome back and thanks for putting up here a follow up query. I am happy to assist you. I will answer every bit of your concerns against every query here under.

1. CT scan said: QUESTION OF MILD COLITIS, POSSIBLY SECONDARY. Secondary to what?
Colitis can be secondary to the use of antibiotics; Pancreatitis; Radiotherapy,chemotherapy; immune deficiency disorders etc.

2. Does colitis need to be treated or does it go into remission?
Colitis is the infection of colon. If the causative agent is removed--no exposure anymore--yes it may go away. But bacterial infection of the colon may need proper treatment. Ulcerative colitis needs proper management too. That's why I asked you to go for a Gastroenterologist consultation.

3. Should I be concerned regarding the Aortoiliac Atherosclerotic disease? The surgeon never mentioned any concerns. Said I did great during the Lapo surgery and I was basically in good health?
Your atherosclerotic disease seems to be mild otherwise your treating Physician must have gone for its follow up. No worries as we don't have to do for it if this is inconclusively milder one.

4. Said heart was normal size?
This is good to have a normal sized heart.

5. The 150 ALP blood test, could this be related to colitis?
No--Not related to colitis usually. ALP gets high in biliary obstruction, bone disease and inflammation of liver.

6. I do not have blood in bowel movements, no stomach pain, basically all I have is a little nausea in the morning, weakness and fatigue, some loose bowels. Concerns?
Such issues can be managed by the use of Pantoprazole/Levosulpiride and if still nauseated use of Ondansetron is the best option.

FINDINGS:

Normal heart size. Minimal atelectasis in the dependent lung bases. No
effusions?
This is not a concern of medical attention. All ok and age related.

Normal appearance of the liver, spleen with adjacent splenule, and
adrenal glands?
All normal. No issues.

Mildly dilated gallbladder measuring 8.7 cm in long axis. Minimal
prominence of the bile ducts. No intraluminal filling defects?
All normal. No issues. mild changes-no harm.

Mild to moderate diffuse edema of the pancreas with surrounding fluid
and stranding. No focal fluid collections?
Not a big issue if we see whole scenario.

Tiny bilateral renal cortical low attenuation lesions, too small to
characterize but most likely cysts. No acute genitourinary pathology?
Not an issue for medical concerns.

Postsurgical absence of the uterus. Non Identified ovaries?
OK.

Unremarkable noncontrast evaluation of the stomach and small bowel.
Normal appendix.
All OK.

Normal caliber colon. Mildly prominent appearance of the walls of the
mid transverse colon through the descending colon, with part of the
splenic flexure coursing near the peripancreatic inflammation. No
adjacent inflammation elsewhere?
Not so remarkable colon, just a mild inflammation around the pancreas ( I will say mild pancreatitis).

No free air. Aortoiliac atherosclerotic disease without aneurysm. No
abdominal wall hernia. No pathologic adenopathy on the basis of CT
size criteria.
Already answered.

Mild scoliosis. Prominent L5-S1 degenerative disc disease. Less
pronounced degenerative changes at other levels. No acute or
suspicious osseous abnormalities?
All age related changes, no major deformity.

Also, can I take Cipro and Ibuprofen? Cipro was for a possible sinus infection. Don't want to upset my stomach??
I don't think you need to take an antibiotic at your own. Don't take it. You may take Tylenol for pains. But taking Pantoprazole/Levosulpiride is necessary. Ask your Gastroenterologist for the same.

Hope I answered all of your queries. Let me know if you have further clinical concerns or doubts. I will be more than happy to get back to you with my expert opinion. Please don't forget to rate to help me assist patients in a better way; and, please don't forget to 'Close This Discussion'.
For any disease you have, a timely follow-up is very necessary regarding the treatment efficacy and to see if there is a need to change the treatment options. So keep a follow up to see how you doing (Always write down my name in start of your questions at this forum & I will be with you in no time).


Regards!
DR. HANIF
USA
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
default
Follow up: Dr. Muhammad Hanif (22 hours later)
Ok, thanks for responding. Then please tell me why I feel like I did before my surgery. The pressure in my abdominal area, pressure on rectum, nausea.
Real shaky. I thought about going to the ER but felt it wasn't appropriate. I belch quite a bit, too. I took my bp today and it was 136/82. My feet are cold. (maybe because I do not feel 100%) I have always been so healthy. They aren't cold in bed at night. No abdominal pain. Just doesn't feel good to put any pressure on it. I would hate to have a blocked bile duct.
doctor
Answered by Dr. Muhammad Hanif (1 hour later)
Brief Answer:
It is not a blocked bile duct. Please don't worry!

Detailed Answer:
Thanks for consulting me at virtual clinic. Your trust in HCM means a lot to me as a Physician.
I have completely reviewed your health query, and can well realize all those concerns. Being your physician, I will take care all of them today and will give extend my expertise to solve the problems.

Pressure feelings in abdominal areas and rectal area needs Colonoscopy to reveal what is going on inside there. Your Gastroenterologist will help you for that. It can be anything ranging from minor inflammation of the intestines to some serious disease of colon or rectum including the hemorrhoids. This kind of feeling also comes due to cramping in the abdominal area.

For better gut motility you need to take more of a high fiber diet as explained in my previous answers. It will help you to get relief from this pressure feeling. Add Pantoprazole/Levosulpiride before breakfast for better results. If you feel nauseated ask your Physician to add a prescription for Ondansetron. You will feel better with these medications.

Cold feet may be just because of weather as they are not cold all the time. I suggest you to try fleece shoes all the time for better warmth. If you don't feel better even with that, ask your physician to check your Thyroid profile too.
Your BP is not that bad. Are you taking any blood pressure medications?? What is the usual range of your blood pressure whenever checked?
Are you Diabetic?? If not, have you ever been screened for it? It is necessary because Gastroparesis is a condition which is due to diabetes and causes the symptoms you are feeling.

It doesn't feels to be blocked bile duct as in that case your test results must had been very very high especially the ALP.


Hope I answered all of your queries. Let me know if you have further clinical concerns or doubts. I will be more than happy to get back to you with my expert opinion. Please don't forget to give Five Star rating to help me assist patients in a better way; and, please don't forget to 'Close This Discussion'.
For any disease you have, a timely follow-up is very necessary regarding the treatment efficacy and to see if there is a need to change the treatment options. So keep a follow up to see how you doing (Always write down my name in start of your questions at this forum & I will be with you in no time).


Regards!
DR. HANIF
USA

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
default
Follow up: Dr. Muhammad Hanif (23 minutes later)
No bp medication. Blood pressure usually around the normal range. I am not diabetic. Thyroid has been checked. What is pantaprazole? I am getting a bit anxious over all this. I do not have a Gastro Doctor, yet. My stomach feels relief when I go to bed and lay on my sides and even on my stomach. Keep worrying about that artery disease maybe being the problem. I am a worrier.
doctor
Answered by Dr. Muhammad Hanif (11 minutes later)
Brief Answer:
Colonoscopy will reveal the truth about your gut!

Detailed Answer:
Welcome and thanks for consulting back with a follow up query and giving me the details to review.

Yes-Pantoprazole is a drug the keeps the stomach acid in check. Stomach acidity is a major cause of concern in patients pre and post surgery especially they are pre-apprehensive about some serious issue. Anxiety, spices, western diet are some factors that cause this issue and tightness, burning sensations, cramping pain or heartburn can be the symptoms in patients depending on the severity.

Keep trying the positions which give you the relief and keep on sticky to them. I advise you to at least once consult a Gastro Doctor. It is necessary for you and beneficial too as colonoscopy will give some clues. He may also go for some more tests if he feels necessary.

It is a positive sign that you have a good BP control and no diabetes.

Hope I answered all of your queries. Let me know if you have further clinical concerns or doubts. I will be more than happy to get back to you with my expert opinion. Please don't forget to give Five Star rating to help me assist patients in a better way; and, please don't forget to 'Close This Discussion'.
For any disease you have, a timely follow-up is very necessary regarding the treatment efficacy and to see if there is a need to change the treatment options. So keep a follow up to see how you doing (Always write down my name in start of your questions at this forum & I will be with you in no time).


Regards!
DR. HANIF
USA

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
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Dr. Muhammad Hanif

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Practicing since :2009

Answered : 2369 Questions

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What Does Blood Alkaline Phosphatase Level 150 Indicate?

Brief Answer: This is not such a high value for ALP to get scared in the first place. Detailed Answer: Thanks for consulting me at virtual clinic. Your trust in HCM means a lot to me as a Physician. I have completely reviewed your health query, and can well realize all those concerns. Being your physician, I will take care all of them today and will give extend my expertise to solve the problems. The normal levels for ALP may range between 45-148 IU/L. Normal values may vary from laboratory to laboratory. Your values for ALP are not that much high to cause a medical concern needing immediate intervention. But this test will serve as a baseline for future comparison to see if the levels come down or go up. At this age your blood work is extraordinary and you are doing good. Slight biliary obstruction, bone disease or inflammation of liver may sometimes cause a bit change in ALP levels. But if the Levels go up many folds the normal limits then it is a sign of concern. Weakness, dizziness, uneasy stomach, and mild diarrhea are all natural after having gall bladder removed. Try less fats in diet, more of vegetables, fruits and salads. Keep Citrucel Dietary Fiber supplement in diet. Take plenty of water and try to remain physically active as much as you easily can. For future:- You need to repeat the same test after 6-8 weeks for comparison with these results. Hope I answered all of your queries. Let me know if you have further clinical concerns or doubts. I will be more than happy to get back to you with my expert opinion. Please don't forget to give Five Star rating to help me assist patients in a better way; and, please don't forget to 'Close This Discussion'. For any disease you have, a timely follow-up is very necessary regarding the treatment efficacy and to see if there is a need to change the treatment options. So keep a follow up to see how you doing (Always write down my name in start of your questions at this forum & I will be with you in no time). Regards! DR. HANIF USA