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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Pain Below The Rib Cage With Elevated Liver Enzymes?

Hi, The last week I have been having strange pains on right side just below rib cage, and other various little pains. At night time, I wake up and feel like I have a sour stomach. My liver enzymes were "slightly elevated" 2 weeks ago. Do you think I am starting to have liver issues? Yes, I have been on Diflocan which can effect the liver.
Thu, 5 Jan 2017
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General Surgeon 's  Response
Hello and welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advice.

I have read your symptoms and understand your concerns. Pain under rib cage as you describe and the feeling of a sour stomach, might correlate with the presence of the gallstones. Usually,liver doesn't have a symptom like pain in most of it's problems. And as you have written, you have slightly liver enzymes which correlate with the presence of the gallstones,the use of Diflocan, or other medications,or even a glass of alcohol. If I was your caring doctor.

I would recommend an ultrasound of your abdomen to check for gallstones or any problem of the biliar ducts, and pancreas. Also I would recommend to do liver enzymes,pancreas enzymes at least 1 month to 2 months after the last lab tests that you did to see if the liver enzymes are back to normal or not. If these tests are normal, than probably you need to do a fibrogastroscopy to check your stomach.

I would recommend to not take medication like ibuprofen, paracetamol, and to not use alcohol. This way your liver will recover faster. Have plenty of water, eat fresh fruits and vegetables. Exercise will help your liver and your whole body. Have healthy diet, low fat products, fish, olive oil etc.

Hope I have answered your query. If you have any other question, feel free to ask me.

Regards,
Dr. Endri Katro
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What Causes Pain Below The Rib Cage With Elevated Liver Enzymes?

Hello and welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. I have read your symptoms and understand your concerns. Pain under rib cage as you describe and the feeling of a sour stomach, might correlate with the presence of the gallstones. Usually,liver doesn t have a symptom like pain in most of it s problems. And as you have written, you have slightly liver enzymes which correlate with the presence of the gallstones,the use of Diflocan, or other medications,or even a glass of alcohol. If I was your caring doctor. I would recommend an ultrasound of your abdomen to check for gallstones or any problem of the biliar ducts, and pancreas. Also I would recommend to do liver enzymes,pancreas enzymes at least 1 month to 2 months after the last lab tests that you did to see if the liver enzymes are back to normal or not. If these tests are normal, than probably you need to do a fibrogastroscopy to check your stomach. I would recommend to not take medication like ibuprofen, paracetamol, and to not use alcohol. This way your liver will recover faster. Have plenty of water, eat fresh fruits and vegetables. Exercise will help your liver and your whole body. Have healthy diet, low fat products, fish, olive oil etc. Hope I have answered your query. If you have any other question, feel free to ask me. Regards, Dr. Endri Katro