Liver problems in Crohn's

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vandygrad97
Regular Member


Date Joined Nov 2003
Total Posts : 66
   Posted 6/9/2009 7:49 PM (GMT -7)   
Hi friends,
 
Just got back some blood work from my Rheumatologist at it showed my LFT (liver function tests) to be elevated quite a bit.  My alkaline phosphate was 217 (normally below 126), my AST was 103 (normally below 45) and my ALT was 221 (normally below 45).  I also had a high ESR at 38 (normally below 20) and high c-reactive protein at 2.3 (normally 0). Sorry for all the numerals!
 
I thought my crohn's was in remission since I wasn't having any bowel symptoms, but my rheumatologist thinks it's active.  He also believes there to be a problem with my liver. 
 
Has anyone else experienced high levels of these LFT's and inflammatory tests? Can these be connect to Crohn's?
 
Please advise, thanks. 
We are the music makers, we are the dreamers of dreams. . .
 
Diagnosed at age 26 with small bowel Crohn's disease; also have enteropathic arthritis, fibromyalgia/myofascial pain syndrome, gallstones and gallbladder removal, kidney stones,erythema nodosum, eye inflammation, hiatal hernia, GERD, lactose intolerant, migraines, Vitamin B-12 deficiency
 
Waiting on probable Multiple Sclerosis diagnosis from Johns Hopkins-abnormal MRI containing 9 lesions, experiencing headaches, blurred vision-possible Optic Neuritis, dizziness, numbness/tingling, vibration sensation while resting, muscle weakness, Vitamin D deficiency
 
Medications: Pentasa, Nexium, Salsalate, Lactose pill, Tramadol


jhicks
Regular Member


Date Joined May 2009
Total Posts : 177
   Posted 6/9/2009 8:09 PM (GMT -7)   
I have not had this experience. But my most recent blood tests did show a slight elevation in LFTs. I had a liver ultrasound and it appeared normal. They are monitoring my blood periodically to keep an eye on it. I am also on Pentasa, and while my gut isn't bothering me, I am having continual ankle swelling and periodic migratory arthritic pains in my knees and jaw.

You have certainly been through a lot as I read your history. Sending healing thoughts and prayers your way. Best of luck!

vandygrad97
Regular Member


Date Joined Nov 2003
Total Posts : 66
   Posted 6/9/2009 8:12 PM (GMT -7)   
Wow, Jhicks!

That sounds just like me! I took Pentasa for a while, but have been off of it for over a year now. I also have pain and swelling in my ankles, severe arthritic pain and stiffness. My bowels are as normal as they've ever been, so all of this seems strange to me. Very interesting...Thanks for the kind words! Best of luck to you as well!
We are the music makers, we are the dreamers of dreams. . .
 
Diagnosed at age 26 with small bowel Crohn's disease; also have enteropathic arthritis, fibromyalgia/myofascial pain syndrome, gallstones and gallbladder removal, kidney stones,erythema nodosum, eye inflammation, hiatal hernia, GERD, lactose intolerant, migraines, Vitamin B-12 deficiency
 
Waiting on probable Multiple Sclerosis diagnosis from Johns Hopkins-abnormal MRI containing 9 lesions, experiencing headaches, blurred vision-possible Optic Neuritis, dizziness, numbness/tingling, vibration sensation while resting, muscle weakness, Vitamin D deficiency
 
Medications: Pentasa, Nexium, Salsalate, Lactose pill, Tramadol


jhicks
Regular Member


Date Joined May 2009
Total Posts : 177
   Posted 6/9/2009 8:17 PM (GMT -7)   
Well, my Crohn's IS active. I had a colonoscopy 3 weeks ago that confirmed it, though I'm still really not having problems with my gut. My one ankle has been swelling and hurting for nearly 4 months now. I read today that joint pain can be a side effect of Pentasa. I wonder if it's related to that or the Crohn's or both. My GI wants to put me on Remicade eventually, but would like to put me on Imuran first. I don't want to go on either if I can help it, so I've been doing acupuncture and an assortment of herbs and vitamins. Did your ankles and such start hurting while still on Pentasa? I'm still on it and have been on it for four years.

vandygrad97
Regular Member


Date Joined Nov 2003
Total Posts : 66
   Posted 6/9/2009 8:35 PM (GMT -7)   
My ankles began hurting about 6 months ago, but I had been off of Pentasa for over a year. I don't know what is causing it. I had a joint/bone scan that was normal. My ankle hurts when you touch it and when I walk. I am only taking Nexium right now. I go back to my GI on the 22nd, so I am sure he'll have me begin some medication. It is also past time for me to have a colonoscopy. That should say a lot. Wow. I always assumed crohn's would only be active if your bowels were moving a lot. I had no idea...
We are the music makers, we are the dreamers of dreams. . .
 
Diagnosed at age 26 with small bowel Crohn's disease; also have enteropathic arthritis, fibromyalgia/myofascial pain syndrome, gallstones and gallbladder removal, kidney stones,erythema nodosum, eye inflammation, hiatal hernia, GERD, lactose intolerant, migraines, Vitamin B-12 deficiency
 
Waiting on probable Multiple Sclerosis diagnosis from Johns Hopkins-abnormal MRI containing 9 lesions, experiencing headaches, blurred vision-possible Optic Neuritis, dizziness, numbness/tingling, vibration sensation while resting, muscle weakness, Vitamin D deficiency
 
Medications: Pentasa, Nexium, Salsalate, Lactose pill, Tramadol


Keeper
Veteran Member


Date Joined Jun 2008
Total Posts : 1058
   Posted 6/9/2009 8:35 PM (GMT -7)   
No experience with Crohn's and liver problems, but they ARE connected. See: Science Daily

Keeper
Veteran Member


Date Joined Jun 2008
Total Posts : 1058
   Posted 6/9/2009 8:42 PM (GMT -7)   
vandygrad97 - what are you doing for your vitamin D deficiency? Recent reports suggest that vitamin D deficiency may be related to the onset of several different autoimmune problems. Also, acid reflux is commonly a symptom of gut inflammation. The histamine from the gut inflammation causes acid secretion in the stomach - for gut inflammation that lies near the stomach. Joint problems may also be Crohn's-related (possibly Crohn's arthritis).

sammies
Regular Member


Date Joined Feb 2008
Total Posts : 493
   Posted 6/9/2009 8:54 PM (GMT -7)   
My last alk phos was 327! Follow up blood work showed high level of smooth muscle antibodies --my body attacking its liver. Autoimmune here we go again. (My AST and ALT were normal). So I went for a liver biopsy 2 Fridays ago. GI said possibility of 3 different conditions: Autoimmune hepatitis, Primary Bilary sclerosis, or Primary Biliary Cirrohsis. I'm waiting on the results--he left for a week and the results had yet to come in. UGH!!!!!!!

Anyway, he says--and I've read lots--that this common in crohn's folks and folks with autoimmune diseases. There is nothing I did to cause whatever disorder I might have. Interesting that in December, I had perfectly normal liver functions--I was on pentasa and humira at the time. I'm no longer on either.

Keep us updated. We are in this together.
24+ years with Crohn's/colitis; fistulizing crohn's; ileostomy and proctocolectomy; propranolol and xanax; been on a ton of crohn's meds; praying to get through each day.


GDen
Veteran Member


Date Joined May 2009
Total Posts : 703
   Posted 6/9/2009 10:22 PM (GMT -7)   
During my first flare my ankle got really bad. First it just hurt to walk on it. Then it actually started turning purple (making me think perhaps I banged it up badly). It really stiffened up if I didn't walk on it for a while. It was quite sensitive to touch (many times I accidentally bumped it, which was intensely painful) and pretty swollen. I used a cane to get around quite a bit. In the hospital, they took x-rays of it. An orthopedist (or might have been a rheumatologist) even drew fluid from it to make sure it wasn't infected. When the docs finally put me on prednisone, I went from needing a walker to hobble around to walking around pretty well (though a bit slowly with a ginger limp) in less than 12 hours. A couple days later I started Asacol. It took a couple of months before my ankle felt like it was back to around 100%.

Since then, I've had minor ankle and hip pain. Nowhere near as bad as my ankle the first time, but enough to make me wince and limp a bit. It usually doesn't last more than a few days though.

PSA
Regular Member


Date Joined Jan 2009
Total Posts : 498
   Posted 6/10/2009 3:37 AM (GMT -7)   
Hi Vandy
I have also heard that Crohns and liver problem are associated. In any case, after reading your profile/signature, I must compliment that you are really brave to withstand all these problems. I can never imagine that one can have such strong will power and fighting spirit. Take Care. God Bless you.
45 years Male Attorney
Diagnosed UC October 1989
 
Had two stage J Pouch Surgery Nov 2005; Take Down March 2006
Complications after surgery - Incisional Hernia and Ano Fistulas
 
"There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle: Albert Einstein
 
"What you are aware of you are in control of; what you are not aware of is in control of you."
 


Wolfie40
Veteran Member


Date Joined Dec 2008
Total Posts : 947
   Posted 6/10/2009 4:05 AM (GMT -7)   
I heard that Crohns and liver problems went hand and hand together, I should ask my doctor about my liver panels and see if they are normal. My father died 2 years ago at the age of 69 from Cirrohsis of the liver and he did not drink alcohol.
Diagnosed with Crohns in 2001
First and hopefully last Ileocecectomy 2/18/2009

Medications: Asacol, Folic Acid, Multivitamin, Dbl. Calcium, Probiotics, Protonix, Monthly B-12 injections.

Living a Great life with my Wife and my two Chocolate Labs
Hunter & Hailey.
I love them dearly.


jhicks
Regular Member


Date Joined May 2009
Total Posts : 177
   Posted 6/10/2009 7:31 AM (GMT -7)   
Vandy: I just read on another thread here someone suggesting that you could take digestive enzymes instead of Nexium - with success and far fewer side effects/dependence issues.
My ankle also hurts to walk on it and is sensitive to touch - sometimes on the inside of the ankle bone, sometimes on the outside - hence the migratory nature of Crohn's arthritis! I swear, I'm only in my 30s, but now with this DD, I walk and sometimes feel like I'm in my mid-60s or older!!

ZenaWP
Veteran Member


Date Joined Aug 2007
Total Posts : 884
   Posted 6/10/2009 9:29 AM (GMT -7)   
Vandy, I've had problems with elevated liver enzymes on and off for a few years.  First GI thought it was just due to prep for colonscopy, as that's when they noticed it and it went back down afterwards.  Two years ago, I went through a very long period with it being very high (said it could have been the 6mp, but enzymes were high before I started it).  We did a liver biopsy, ERCP, MRCP (one of those caused 3 days in the hospital with pancreatitis) and all just showed my bile ducts were inflammed but no reason.  Enzymes went back down (but then up again when I started sulfasalazine, back down when I stopped it).  So,
I would check and see if your meds could be causing it. 
Crohn's Disease, Acid Reflux/Gastritis, Hashimoto's Thyroiditis, Endometriosis, Arthritis, Depression/Anxiety.  Too many meds to list them all.  =) 


MikeB
Veteran Member


Date Joined Mar 2006
Total Posts : 1169
   Posted 6/10/2009 12:30 PM (GMT -7)   
There is a condition called chronic persistent hepatitis which can be associated with a number of autoimmune diseases and which generally exhibits no symptoms and is found from elevated liver enzymes. Might google that. It usually resolves without treatment but normally requires a liver biopsy to diagnose for sure. I had this about 25 years ago, discovered on a routine blood test and confirmed by biopsy,  and it resolved within 6 months. My GI said he sometimes sees it in Crohns patients. Of course elevated liver enzymes can be a sign of a number of different conditions, so full diagnostic testing to nail it down is essential

vandygrad97
Regular Member


Date Joined Nov 2003
Total Posts : 66
   Posted 6/10/2009 12:49 PM (GMT -7)   
Thanks for all of the words of encouragement and help! I went to my internist today to get her take on it all, until I see my gastro on the 22nd. She also mentioned it being possibly connected to Crohn's through the bile ducts as PSC or PBC. Autoimmune Hepatitis was also mentioned. Wow. I don't think I realized the severity of this disease, or at least, have gone into denial that there could be serious side effects. I've had just about every possible extra-intestinal complication, but am hoping the liver enzymes are not a sign of any of these other liver conditions. So scary...I'll keep y'all posted.

I do feel a flare coming on, although, I thought I was in remission. My bowels have been crazy today, but that could also be stress. Who knows any more.
We are the music makers, we are the dreamers of dreams. . .
 
Diagnosed at age 26 with small bowel Crohn's disease; also have enteropathic arthritis, fibromyalgia/myofascial pain syndrome, gallstones and gallbladder removal, kidney stones,erythema nodosum, eye inflammation, hiatal hernia, GERD, lactose intolerant, migraines, Vitamin B-12 deficiency
 
Waiting on probable Multiple Sclerosis diagnosis from Johns Hopkins-abnormal MRI containing 9 lesions, experiencing headaches, blurred vision-possible Optic Neuritis, dizziness, numbness/tingling, vibration sensation while resting, muscle weakness, Vitamin D deficiency
 
Medications: Pentasa, Nexium, Salsalate, Lactose pill, Tramadol


sammies
Regular Member


Date Joined Feb 2008
Total Posts : 493
   Posted 6/10/2009 3:29 PM (GMT -7)   
Vandy-- don't feel bad about not knowing about the crohn's/liver disease correlation. I was diagnosed 25 years ago and I research all the time--don't know how I missed it.

So, my GI's office called today. My biopsy results are in but GI is away for another week. I won't see him til June 19. I'm going nuts. while I do want to talk to HIM about all this, I'm wondering if I should call and ask that one of his partners call to give me a diagnosis. I hesitate b/c I know this is not a cut and dry type issue.

Still hoping whatever it is resolves.

Keep us updated.
24+ years with Crohn's/colitis; fistulizing crohn's; ileostomy and proctocolectomy; propranolol and xanax; been on a ton of crohn's meds; praying to get through each day.


vandygrad97
Regular Member


Date Joined Nov 2003
Total Posts : 66
   Posted 6/10/2009 5:56 PM (GMT -7)   
Sorry for all of the waiting, Sammies. I know it is excruciating to sit around waiting for a diagnosis. Especially when you can do so much research on the web these days and most of it is information you don't want to hear. I would call the practice and have another doc interpret the results for you. I think that is totally fair. They shouldn't leave you hanging. That happened to me a million times this past year. First they thought I had MS, then rheumatoid arthritis, then lupus. All have been ruled out. Apparently, Crohn's can cause abnormal brain lesions. Who knew!? I was going to the MS center at Johns Hopkins, so if anyone knows their stuff, they do. Now I'm see a gastro, also at JH that is one of the best in the country. I go in on the 22nd, so hopefully, we can get to the bottom of things. No pun intended! HAHAHAHA
I hope you hear the results very soon and that they are positive! Keep me posted!
We are the music makers, we are the dreamers of dreams. . .
 
Diagnosed at age 26 with small bowel Crohn's disease; also have enteropathic arthritis, fibromyalgia/myofascial pain syndrome, gallstones and gallbladder removal, kidney stones,erythema nodosum, eye inflammation, hiatal hernia, GERD, lactose intolerant, migraines, Vitamin B-12 deficiency
 
Waiting on probable Multiple Sclerosis diagnosis from Johns Hopkins-abnormal MRI containing 9 lesions, experiencing headaches, blurred vision-possible Optic Neuritis, dizziness, numbness/tingling, vibration sensation while resting, muscle weakness, Vitamin D deficiency
 
Medications: Pentasa, Nexium, Salsalate, Lactose pill, Tramadol

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