Liver Doctor

[axcel_v]

My father has very high level of alkaline phosphatase. I learned thru research that it may be caused by liver or bone disease. I ned your help. Ano bang doctor ang lalapitan namin for such. Ang doctor kasi ng father ko, gastroenterologist...eh parang commercialized doctor. gustong ipa-ct scan si papa to think pina-endoscopy na siya at pina-ultrasound.

Hope for your help. Thanks a lot.

[matulis]

My father has very high level of alkaline phosphatase. I learned thru research that it may be caused by liver or bone disease. I ned your help. Ano bang doctor ang lalapitan namin for such. Ang doctor kasi ng father ko, gastroenterologist...eh parang commercialized doctor. gustong ipa-ct scan si papa to think pina-endoscopy na siya at pina-ultrasound.

Hope for your help. Thanks a lot.

Axcel,

An increase in alkaline phosphatase may be a sign of bile duct obstruction. This can be caused by bile duct stones or a tumor anywhere in the liver, bile ducts, pancreas or duodenum. I believe the request done by your dad's physician is valid. I would probably have requested those test myself if I were his physician. He is probably searching for a tumor or a stone which was not seen on endoscopy or ultrasonography.

It is true that bone diseases may cause an increase in Alk Phos., this is true especially if one has bone tumors or osteomalacia. However, in the absence of bone symptoms and since Alk Phos is mostly made in the liver than the bone, and with other tests like CBC and x-rays showing no bone lesions, then the search for a liver related problem is warranted.

Tumors in the liver area might not be curable if the diagnosis is delayed that is why your dad's physician is taikng an extra effort to exhaust all possible means to detect a disease which might be occult at the present time.

On the other hand, there is a subset of patients wherein their normal laboratory values are higher than usual. If all things were considered with the present diagnostic modalities and nothing was seen then we can conclude that he belongs to that subset of people with normal values slightly higher than the general population.

Can you ask your dad if he is taking cholesterol lowering drugs such as Lipitor or Crestor? this might elevate the alk phos level too.

Also, did you consider a repeat of the test to eliminate the possibility of a lab error? It happens even on expensive hospitals and in developed countries.

I hope I did not confuse you. Napa-sobra ata ang reply ko.

[internist]

I agree with matulis. I would have done the same thing and exhaust everything to search for an elevated alk phos.

Naninilaw ba dad mo or meron ba siyang abdominal pain?

[axcel_v]

thanks so much for your prompt & helpful advice. Hindi naman naninilaw si Papa. Pero he usually had occasional fever. Ngayon wala. Talaga bang CT scan na ang best na procedure to check on the liver? Kasi siyempre it's quite expensive.

[internist]

Its the best next step in my opinion especially to rule out liver masses.
If its clear, then at least meron kayong konting peace of mind.
Sometimes infection can also cause an increase in alk phos. Sana yun lang.

[ferkhite]

Doc,Sirs, Advice naman po sabi po ng Dr. ng mom ko may bukol daw yung liver niya maliit lang daw di naman daw kailangan operahan or magpanic / magalala dahil maliit lang daw po sobra , obserbahan daw lang muna kaya minomonitor namin so far ganun pa din di lumalaki yearly minsan every 6 months ultrasound siya para mamonitor, CT scan pati MRI niya ok naman, possible po kaya ito na di dapat magpanic? 2 doctor na po pinuntahan namin same diagnosis po sila...salamat po

[internist]

Kung wala naman symptoms mom mo and yung AFP or alpha feto protein niya is normal plus wala kayong history ng liver cancer. Add mo pa na ilang beses na na ultrasound ang mom mo without the mass increasing in size, I guess observation lang talaga kailangan.
Sinabihan ba kayo kung anong klaseng mass siya? Did they say hemangioma?

[axcel_v]

doc, ask ko lang sa ultrasound kasi ng father ko saliver niya, nakalagay dun na normal size daw ang liver niya with fatty changes then there was a note that there's bilial ductal dilatation. what does it mean po? Thank you po.

[matulis]

doc, ask ko lang sa ultrasound kasi ng father ko saliver niya, nakalagay dun na normal size daw ang liver niya with fatty changes then there was a note that there's bilial ductal dilatation. what does it mean po? Thank you po.

A biliary duct dilatation means that the ducts carrying the bile produced from the liver towars the intestines are probably obstructed. There must be something causing it. It could be a stone, a tumor or a stricture.

[ferkhite]

Kung wala naman symptoms mom mo and yung AFP or alpha feto protein niya is normal plus wala kayong history ng liver cancer. Add mo pa na ilang beses na na ultrasound ang mom mo without the mass increasing in size, I guess observation lang talaga kailangan.
Sinabihan ba kayo kung anong klaseng mass siya? Did they say hemangioma?

Sir hindi po,"sabi" po nung 2 dr. no need to worry daw po, wala pong nabanggit na hemangioma observation lang daw po kelangan , paglumaki siya dun lang po daw gagalawin...thank you po sa reply :)

[internist]

Great. Just follow up with your doctor regularly as instructed :)
God Bless.

[Ventada Manila]

Hi doctors. Napapraning lang ako. Everytime I drink (kahit 1 bottle of San Mig Light lang), my stool is black for the following two days then goes back to normal brown. I had Hepa A last May. I started drinking again in small dosages after four months.

Is there something wrong with my liver? My abdomen has felt tender ever since I recovered from Hepa A. What does that mean?

[matulis]

Hi doctors. Napapraning lang ako. Everytime I drink (kahit 1 bottle of San Mig Light lang), my stool is black for the following two days then goes back to normal brown. I had Hepa A last May. I started drinking again in small dosages after four months.

Is there something wrong with my liver? My abdomen has felt tender ever since I recovered from Hepa A. What does that mean?

Black stools could be a sign that you have bleeding in your stomach. When blood mixes with acid, the color is converted to black. Gastric ulcer is a common cause of a bleeding stomach. This condition is associated with abdominal pain.
I am not sure about the role of alcohol with your symptoms. It could be that stress brought about by alcohol drinking might predispose one to get into a gastric ulcer.

Some food supplements especially those with high in iron can cause a black colored stool. Check out if you have these in your diet.

With regards to Hepa A last May. By this time you should be out of the doldrums.

[Ventada Manila]

Black stools could be a sign that you have bleeding in your stomach. When blood mixes with acid, the color is converted to black. Gastric ulcer is a common cause of a bleeding stomach. This condition is associated with abdominal pain.
I am not sure about the role of alcohol with your symptoms. It could be that stress brought about by alcohol drinking might predispose one to get into a gastric ulcer.

Some food supplements especially those with high in iron can cause a black colored stool. Check out if you have these in your diet.

With regards to Hepa A last May. By this time you should be out of the doldrums.

Last night, I ate so much greasy beef cooked so well that it looked black already. I drank a bottle of San Mig Light after. My abdomen doesn't feel painful but tender. As if my insides have a squash texture. If the black stool leaves after two days, does that mean I'm ok or the fact that I already had black stool means something is seriously wrong with me?

[matulis]

Last night, I ate so much greasy beef cooked so well that it looked black already. I drank a bottle of San Mig Light after. My abdomen doesn't feel painful but tender. As if my insides have a squash texture. If the black stool leaves after two days, does that mean I'm ok or the fact that I already had black stool means something is seriously wrong with me?

Well... If the food you are taking seems to be the culprit then you need not worry.

But if you would like to have a piece of mind, you can consult your doctor.

[Ventada Manila]

Well... If the food you are taking seems to be the culprit then you need not worry.

But if you would like to have a piece of mind, you can consult your doctor.

My stool went back to normal today with small traces of black parts which seem to form art of the feces and at one end only. Must have been the beef. Hehe. I hope. Or maybe I overate so much meat that night (without carbs) that my colon had a hard time so it bled. My abdomen feels kind of tender though but seems to disappear whenever I enough sleep. I usually sleep an average of 4 hours only due to a part-time job in the morning.

Thanks Matulis!:)

[matulis]

My stool went back to normal today with small traces of black parts which seem to form art of the feces and at one end only. Must have been the beef. Hehe. I hope. Or maybe I overate so much meat that night (without carbs) that my colon had a hard time so it bled. My abdomen feels kind of tender though but seems to disappear whenever I enough sleep. I usually sleep an average of 4 hours only due to a part-time job in the morning.

Thanks Matulis!:)

i suggest you still see a doctor, preferrably a gastroenterologist. You still feel symptoms which should not be present.

[internist]

Yup please see a doctor.

[Ventada Manila]

I already sa a family doctor. He said he didn't feel any lump or anything abnormal. Should I still see a gastroenterologist?

[internist]

if you are still having dark or black stools, you definitely should

[Ventada Manila]

No more black stool, it just lasted for a day. The abdominal discomfort has stopped too. But I'll see a gastroenterologist just to be sure. What kind of tests will he give me kaya? SGPT? Aabot pa ba sa ultra sound and CT scan yon?

[internist]

depends on what his impression is of you after he examines and talks to you

[axcel_v]

Doc, this is regarding my father (please refer to the first few posts). Hindi pa rin po namin siya napapa-CT scan. wala pa po kasi kaming pera. Baka may alam po kayong mura na CT scan. The cheapest we have inquired was P9k. Ask ko rin po doc baka pwede po kami magpa-check up sa inyo. Meron po kasi siyang abdominal pain then nagsusuka at nay LBM po siya. worried po kami.
Thank you very much po...

[internist]

hi axcel pm sent