Q. I have chest pain and acid reflux with raised AST and ALT levels. Kindly explain.

Hello,

Welcome to icliniq.com.

I can understand you must be concerned and very upset about your recent onset symptoms and visit to ED for this chest pain. Yes, they are right, that you might have ulcers in the food pipe that has led to chest pain. But you see, the patients with ulcers in food pipe, often have a chronic history of acid reflux and heartburn before they develop ulcers and have significant chest pain because of it.

On the other hand, the ulcer pain or pain due to just acid reflux not necessarily mean that the ulcer can immediately subside with the Famotidine type of medications which suppress acid production within the stomach.

Having said that, the raised AST and ALT are an unusual findings, and in fact may the actual cause underlying your recent development of chest pain and visit to ED. Your ALT and AST are almost x10 times than the normal ranges given your age and gender (attachment removed to protect patient identity). This suggest that you have ongoing inflammation within the the liver. Such high levels of ALT and AST can causes different symptoms within human body, notably, the fatigue, loss of appetite, weakness, acidity, vomiting, and fever. The potential causes underlying such high level of ALT and AST are Paracetomol use in toxic doses or acute viral infections like Hepatitis A, hepatitis E and Hepatitis B infections. Autoimmune hepatitis (AIH), mushroom poisoning and lastly alcohol induced hepatitis.

For me to help you diagnose your case, I would need more information before I can make an impression of one of above causes and then can suggest you some target investigations to confirm the reason underlying deranged ALT and AST. I would urge you to provide more information, as we can shrink the list of differentials and can confirm the cause by relevant investigations. And lastly to treat it appropriately. It is possible that you may need some time for observation (such as in Paracetamol poisoning and alcohol related liver inflammation and some viral infection like Hepatitis A infection); or may need some more close monitoring and start of treatment (such as hepatitis B, mushroom poisoning, and Autoimmune hepatitis).

Will recommend relevant testing after detailed information is provided.

For now, just avoid Paracetamol if you were taking, and any other medication which is supposed to damage the liver. Famotidine is fine.

Follow up to provide more information.

Same symptoms doesn’t mean you have the same problem. Consult a doctor now!

Dr. Ajeet Kumar

Experience: 13 + Yrs

Medical Gastroenterology

---

Related Questions:
Is asthma permanently curable?

.. son is premature, it does not matter with the present illness. Let me first clear you that he is suffering from bronchial asthma. And anyone can have asthma without any family history. So, it is not necessary to be always run in families. To conf...   Read full

My asthmatic mother's X-ray is negative for TB. What else this could be?

.. checked the attached report, along with the data you provided (attachment removed to protect patient identity). Your mother has COPD which is a chronic obstructive lung disease due to changes in the lung with age and due to smoking. In COPD the ai...   Read full

Can severe acid reflux turn my teeth translucent, and cause gums to recede?

.. that you have explained are right. If you have acid reflux problem and in your case, it looks like there is too much of acid refluxing in your mouth from the stomach. This acid can erode your teeth making the enamel thin due to loss of minerals. I...   Read full