Question:
elevated liver enzymes one month post op??

I received a phone call from my family physician this evening regarding my blood work. I had my labs done last week as i am one month post op. She is very concerned about my liver enzymes being so elevated. I have always had elevated liver enzymes due to a fatty liver but these levels are even higher now. I have to retest in one month and if they do not go down i will have to have a ct scan. I also have been throwing up white foamy stuff which i happened to mention to her and she has now taken me off trying any food and put me back on full fluids for awhile. She said the white foamy stuff that i throw up is in fact stomach acid, if i keep that up it will erode my esophagus and put me at risk for esophagus cancer. Geez, what else can go wrong today? Any comments or similiar experiences would be helpful. Thanks so much.    — sassy1696 (posted on April 14, 2009)

April 14, 2009
Are you having the foamy stuff all the time? Your family MD is right in saying that the foamy stuff is your stomach acid but it doesn't have much acid in it as your pouch is so small that most of what is being produced is mucous trying to help food go down. I have had large amount of foamy when I try to eat too fast (mainly at work when I don't have enough time to eat right). If you are having it all the time that doesn't sound normal. Have you contacted your surgeon? She is right about esophageal cancer risk from acid reflux in people with normal stomach acid. I have not seen studies in the medical literature on bypass patients risks given our lower amount of stomach acid. It is also a very long term risk, you've got enough to worry about short term right now. Liver enzymes can go up for a number of reasons and I agree with your MD that it should be looked into if it is not a temporary elevation. I had several patients through the years with significant increases in liver enzymes that I never found out why. I would get ct scans, nuclear scans and even send them to gastroenterologists for consult with no abnormality being discovered and they came back down to normal, so you never know. I had my rny 4 days before you did so we aren't very far out yet. I mainly would reccomend letting your surgeon know what is going on as well as your family MD. It sounds like your family MD has a good plan for work up but (as a family MD myself) I also know that the surgeon has a different perspective and experience that may be helpful to you. Are you on acid blocker of any kind? Pepcid complete is otc and chewable. Hopefully something above is helpful to you. Hang in there. Kevin
   — hapkidodoc

April 15, 2009
Hi, Had the foamies too. But it was ME not able to handle what I was putting in my mouth. Not trying to give advise..but did you call your Dr. that did the surgery? I believe that is the person that will have the best, correct answers for you. Did the surg. go over your intended diet for after care? Did you see a NUT.?
   — tootsie52

April 15, 2009
Well, i tried to call my surgeon and he is on holidays until friday, of course, lol. I am flying out to toronto next wed. for my 6 week post op with the surgeon and to see the dietician. Things are a little different for me as in Manitoba we no longer do any bariatric surgery so I dont have much support except for what i get here. Thank god for this site. I am following what they have told me to try and eat but one day it is fine the next i throw up. My family doctor thinks im not ready for regular food and has put me on full fluids until i see my surgeon next week. So you know what that means; more protein shakes, yuk!! thanks for your advice everyone.
   — sassy1696