Elevated liver and pancreatic enzymes with Asacol?

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Sistermarie
Regular Member


Date Joined Jun 2008
Total Posts : 45
   Posted 7/19/2008 11:07 PM (GMT -6)   
My doctor mailed me the results of the bloodwork I had done on 7/3. The liver enzyme ALT was 114 IU/L. The normal range is between 0-40 IU/L. My bloodwork from before I was on Asacol showed an ALT of 16 IU/L.
 
The pancreatic enzyme Amylase was 125 U/L, and the normal range is 0-99. Not too bad, I guess. The pancreatic enzyme lipase was 185 U/L, with a normal range of 0-59.
 
My doctor also included a presciption for an ultrasound of my gallbladder.
 
I am highly suspicious of Asacol (I'm on 12 pills/day). I am feeling good, and was wondering if this is a typical experience with Asacol, and my doctor is just making sure it's nothing else.
 
Thanks! It's always something.
 
 
Gale--New York Diagnosed with UC 6/9/08
 
On Asacol 4 pills 3x/day
Iron supplement, fish oil, magnesium, caltrate D, cerefolin NAC,
probiotics, alpha lipoic acid.


quincy
Elite Member


Date Joined May 2003
Total Posts : 25590
   Posted 7/20/2008 3:08 AM (GMT -6)   
Hi....yes, 5ASA meds can raise the liver and kidney and pancreas enzymes...
So can liver disease, inflammatory disease, or a blockage in the ducts.

Where exactly in the colon is your UC...limited or thoughout?

What fish oil supplement are you taking?

quincy
*Heather*Status: mini flare Dec 28... tapered to every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol (6 daily) + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 3(Natural Factors Protec) bedtime + 1 (Primadophilus Reuteri) occasionally
~multi-digestive enzymes as needed ....zymactive 3 - 5x daily
~Ranitidine,Pariet (reflux) Effexor XR 75mg;  Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!


Sistermarie
Regular Member


Date Joined Jun 2008
Total Posts : 45
   Posted 7/20/2008 1:24 PM (GMT -6)   
I was diagnosed last month (6/9) with severe ulcerative pancolitis. MY CT scan showed thickening and inflammation throughout, with the worst in the descending colon. The same day as my colonoscopy, I began Asacol 12 pills/day plus 300 mg of budesonide IV for 3 days. My symptoms--all of them--have disappeared and have not returned. No pain, no bleeding, no diarrhea. I am taking one fish oil capsule with breakfast. Any more than that makes me nauseous, but I eat fish regularly.
 
Thing is, all of my blood levels were normal before I began Asacol. That's why I suspect it. I'll call for an ultrasound tomorrow.
 
 
 
 
Gale--New York Diagnosed with UC 6/9/08
 
On Asacol 4 pills 3x/day
Iron supplement, fish oil, magnesium, caltrate D, cerefolin NAC,
probiotics, alpha lipoic acid.


at wit's end
Regular Member


Date Joined Jun 2007
Total Posts : 498
   Posted 4/20/2009 4:32 PM (GMT -6)   
Hey Sistermarie. I have over the past month in two sets of bloodwork shown slightly elevated liver enzymes. I was put back on Asacol 400 mg back I believe about two years ago, not once for some reason has my gastroenterologist had blood drawn since I've been back on it these past two years, where as before when I was on it before, he did every 6 months. My AST is 43 which on my bloodwork results it shows normal range to be 15-39 U/L. My ALT is 53, normal range shows to be 7-52 U/L.
 
I'm hoping this is a result of the drug and I feel it is. My elevated level is mild compared to what yours showed. And my gastro doctors lab work might show a different result, could even be normal. I have to go see them tomorrow morning and let them draw blood themselves and I have to take a copy of the lab work with me for them to see. I know I will be asked questions as I have already been asked one over the phone.
 
I hope things are not as bleak as I feel they are, I do not like problems like this arising. Glad my husband found this for me to read. The doctor even told me Asacol could elevate the readings. However, my AST was normal the time before, I had only the ALT slightly elevated at the time, now both are.
Diagnosed with left sided UC in sigmoid colon and rectum 1986.
Put on Azulfidine 2 X 3 a day and Rowasa enemas 60mg.
Have been pretty much in remission overall other than a few flares over the past 21 years.
Medicine changed to Asacol 400mg 2 pills X3 times a day. Taken off all meds in 2004.
Diagnosed with acid reflux 2005. Put on Protonix 40mg.
Have been using Canasa 1000mg suppositories nightly since January 2007.
Was put back on Asacol 400mg 2 pills 2X a day in July 2007 maintenance. 


Christine1946
Veteran Member


Date Joined Aug 2008
Total Posts : 5453
   Posted 4/20/2009 5:47 PM (GMT -6)   
     Sister Marie....When I was admitted to the hospital about a year ago, my Amylase and Lipase levels were extremely high.  My doctor immediately took me off the 6MP.  At the end of my hospitalization (ten days later) both levels had returned to normal.  Because I was becoming prednisone dependent, the doctor decided to try the 6MP about two months later with close observation of my blood work.  I was able to get off the prednisone Nov 1st and still on the 6MP.  I lowered my dosage from 75 mgm to 50 mgm one day and 25 the next.  The reason being my white count was much too low.  It is now 2.9. Not great, but improved.
     By the way, are you a nun?
62 yr old granny. South Jersey
Diagnosed with ulcerative proctitis in 1998 in hospital
Hospitalized (2nd time) in May 2008
Update 11/03/08...finally in remission!!  Hope I don't jinx myself.  Off the prednisone since 11/01/08...now see if I can stay off for longer than two weeks.  Other meds: 6MP (75 mgm), colazal (6 per day), Benicar and Toprol (high blood pressure meds), Probiotic (2 per day), fish oil capsule and multi-vitamin and calcium with vitamin D.


Shadam
Regular Member


Date Joined Jan 2009
Total Posts : 307
   Posted 4/20/2009 6:06 PM (GMT -6)   

My liver enzymes were also elevated the first time I was admitted in to the hospital back in August of '08 before I was diagnosed with UC.  The liver enzymes have since stayes elevated and I am no on Asacol.  I have had a lot of tests done to find out what the issue exactly was. I actually just had a liver biopsy done (not fun by the way). 

Becuase of the elevated liver enymes, my GI diagnosed me with Primary Sclerosing Cholongitis (PSC), which is an autoimmune liver diesease.  In a nutshell, I have the same issue as UC except its affecting my liver (and I dont have to poop as much). 

I would ask you GI about this because if not monitored, it could become very serious.  Not to scare you but I think this is the same disease that Walter Payton died of. 

Good luck!


Age: 25 / Male / Florida
Diagnosed: 11/08 / Pancolitis
Asacol - 2 x 3 day (waiting for results)
Prednisone / ended 1/09 (started at 30mgs and tapered down)
Mens Multi Vitamin - 1 a day
Calcium & Vitamin D3 - 1200mc of Calcium and 800iu of Vitamin D3
Metamucil Wafers - Once a day
Jaro - Dophilus Probiotic (3.4 Billion) - 1 a day
Diagnosed with PSC: 3/9 --now taking Urso


UC Dude
Regular Member


Date Joined Aug 2005
Total Posts : 438
   Posted 4/20/2009 8:16 PM (GMT -6)   
Shadam said...
My liver enzymes were also elevated the first time I was admitted in to the hospital back in August of '08 before I was diagnosed with UC. The liver enzymes have since stayes elevated and I am no on Asacol. I have had a lot of tests done to find out what the issue exactly was. I actually just had a liver biopsy done (not fun by the way).

Becuase of the elevated liver enymes, my GI diagnosed me with Primary Sclerosing Cholongitis (PSC), which is an autoimmune liver diesease. In a nutshell, I have the same issue as UC except its affecting my liver (and I dont have to poop as much).

I would ask you GI about this because if not monitored, it could become very serious. Not to scare you but I think this is the same disease that Walter Payton died of.

Good luck!


Walter "Sweetness" Payton... one of the best running backs ever.... died of liver cancer. Once the PSC turned cancerous the life saving option of a liver transplant was no longer an option. RIP #34!!
 


CrohnsShortie
New Member


Date Joined Oct 2010
Total Posts : 1
   Posted 5/7/2011 9:26 PM (GMT -6)   
I know I'm really late on this post, but I was noticing that you said you were on IV budesonide? I didn't know that could be IV. I thought it was controlled-release. Is that a common thing?

rpgdancer
Regular Member


Date Joined Sep 2010
Total Posts : 337
   Posted 5/9/2011 10:31 PM (GMT -6)   
i keep being told that my liver enzymes are high because i'm "overweight" but you guys have got me thinking that it might be the 8 pentasa/day that i take (same as asacol but releases sooner in the system). hmmmmmmmmmmm
20 year old female
diagnosed: Ulcerative Colitis, Polycystic Kidney Disease, Pancreatic Cyst, Chronic Migraines, depression, generalized anxiety disorder, and OCD.

Meds: pentasa, protonix, amitiza, kytril, librax, zoloft, trazadone, seraquil, nadolol, necon, potassium citrate, Claritin D

Considering: Remicade

LondonGirl22
Veteran Member


Date Joined Jan 2006
Total Posts : 1629
   Posted 5/10/2011 4:57 AM (GMT -6)   
My bilirubin was raised the other week and they did a scan of my gallbladder and liver to double check everything but they ended up saying that I had Gilbert's Syndrome. Apparantley this is a condition where your bilirubin raises if you are not very well. There's no real reason for it I don't think.
Blood tests can alter with certain medications too so it's always good to double check these things.
Tori xx

Forum Moderator - IBS and UC

aguywithuc
Veteran Member


Date Joined Jun 2010
Total Posts : 2437
   Posted 5/10/2011 7:40 AM (GMT -6)   
Interesting thread. Never had elevated enzymes for anything on asacol. I do have elevated kidney measure now creatinine and uric acid which is likely from a high protein diet. Now pancreatic enzymes you mentioned are digestive enzymes so I would welcome that as I suspect my pancreas is not producing enough. Elevated liver is another matter and I am always happy to see them low, sometimes they spike up to a double.

Key here is my 10 year spreadsheet showing me where these numbers have been for 10 years. If you can find old measurements this will tell you if the current measures are normal for you or an abberation. You can seem my platelet count is all over the map and my creatinine has been higher, bun at 27 is high but I was once 42!


Creatinine 1.4 1.2 1.3 1.4 1.4 1.6 1.4 1.6 1.56 HIGH
eGFR 60 58 53 55 46 48 LOW
Bun 27 13 42 13 19 32 22 13 15 27
Protein 7.2 8.1 7 7 6.6 6.2 6.4
Uric Acid 9.2
AST 34 73 31 43 18 35 40
ALT 63 57 21 37 30 30 37
Glucose 69 87 79 86 142 125 83 90 83

Platelet 268 257 518 283 588 688 499 357 285
RDW 15 12 13 14 14 18 18 21 15.1 HIGH
WBC 5 5 18 4 8 14 11 5
RBC 5 5 4 5 5 4 3.5 5 4.72
HCT 42 47 38 45 35 31 44 47
Vit D 1 34 62
C-Reactive 52 0.47

Labyrinth
Regular Member


Date Joined Jan 2012
Total Posts : 113
   Posted 3/5/2013 3:35 AM (GMT -6)   
Has anyone been on mesalazine meds develop sudden significant increase in liver enzymes? when i say sudden i mean sometime during the 6months between the routine 6 month testing.

Mine have come back high but been fine up until now and the GI said its not the meds as i would've shown a reaction within the first six months. My levels are very high and im not sure i should still be taking them? the levels have actually increased over the past week
36yr old female from New Zealand.

Diagnosed 2011 mod/sev ulcerative Colitis just past sigmoid
Prednisone induced remission May 2012

Maintenance regime Pentasa - 3gm
Mesalazine Enema - every other day
Looking to reduce Pentasa orals in another month?

Elevit
Lysine
Limitted dairy & sugar
Couple wines here & there

quincy
Elite Member


Date Joined May 2003
Total Posts : 25590
   Posted 3/5/2013 2:32 PM (GMT -6)   
You're also pregnant...that can have impact on your levels.
Do more research.
q
*Heather* I give suggestions, do with them what you will.
Status: ...Asacol 3 @ 2x daily; Salofalk enema @ 3rd night (nightly/ flares, tapered/maintenance)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol 20mg as needed; Zantac 150mg; Pulmicort/Airomir (asthma);Effexor XR 37.5 (depression)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care+Primadophilus Reuteri capsules @ bedtime)
~Metamucil capsules 6 twice daily with meals; Vitamin D 4500 IU
~URSO for PBC(or PSC?) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS" worth it !!!

canadamom
Regular Member


Date Joined Oct 2012
Total Posts : 85
   Posted 3/5/2013 9:10 PM (GMT -6)   
My son's are high and he is in mezavant. GI is not convinced it's from the meds though. He has had a liver biopsy and added urso to his daily meds. Next appointment is not till end of April and the GI may change his meds depending on what else is discovered. I know he mentioned PSC. Fingers crossed I'm so tired of not knowing what's happening.

Labyrinth
Regular Member


Date Joined Jan 2012
Total Posts : 113
   Posted 3/6/2013 1:26 AM (GMT -6)   
Canadamom, Yes it can be frustrating hopefully you find out more soon.

Thanks for the "advice" Quincy!
It just so happens im doing a heap of research hence bringing this back to the forum. Im well aware that im pregnant 4.5wks which the Obstetrician feels is too early and unrelated. It was one of the first things we explored. Im aware of a condition that can cause this early in pregnancy and will be discussing further when i have more information.

Quincy, i have learnt a great deal from you and credit my remission partially due to your constant advice to people on here re rectal meds and normally i look forward to reading your words of wisdom. But to be honest i find your comment here a tad patronizing and disappointing. It may very well be your way of letting me know you've read my other post, who knows? Or i could be taking it out of context?? but it took a great deal of courage for me to disclose that information on here so early on and i wouldn't have done it unless i was serious about researching and looking to this site as part of that process - do you have a hint at where i should go from here?

Post Edited (Labyrinth) : 3/5/2013 11:48:34 PM (GMT-7)


quincy
Elite Member


Date Joined May 2003
Total Posts : 25590
   Posted 3/6/2013 10:36 AM (GMT -6)   
I see you answered this thread and not the other one. Yes, this one was concise since it was asked in a thread you started yourself.

I could have expanded on this thread, but didn't because I assumed you would have looked at that thread first. And it wasn't meant in anything other than do the research for other possibilities.

The only way I would know you were pregnant is if I read the other thread.

With the results you have...there are other blood tests your doctor should be doing to take you to the other possibilities.

What I can suggest is that he do an ultrasound of the liver/kidneys to see if there's anything else going on.

As well...I didn't want to bring up primary sclerosing cholangitis or primary biliary cirrhosis...but will now. That was the reason my enzymes were up.
Another possibility is autoimmune hep...but there are blood tests that should be done further to lead in whichever direction.

I'll continue answering your other thread after you comment there....

One thing you might also consider is to lower the dosage of 5ASA...Apriso and lower dosage rectals. If that lowers your emzymes, then it could be the 5ASA.

q
*Heather* I give suggestions, do with them what you will.
Status: ...Asacol 3 @ 2x daily; Salofalk enema @ 3rd night (nightly/ flares, tapered/maintenance)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol 20mg as needed; Zantac 150mg; Pulmicort/Airomir (asthma);Effexor XR 37.5 (depression)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care+Primadophilus Reuteri capsules @ bedtime)
~Metamucil capsules 6 twice daily with meals; Vitamin D 4500 IU
~URSO for PBC(or PSC?) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS" worth it !!!

Labyrinth
Regular Member


Date Joined Jan 2012
Total Posts : 113
   Posted 3/6/2013 11:52 AM (GMT -6)   
Ohhhh Quincy im awfully embarrassed!
I completely overlooked your comment on my other thread - can i blame it on baby brain yet...? Sorry for jumping down your throat like that.

Will respond to the other
36yr old female from New Zealand.

Diagnosed 2011 mod/sev ulcerative Colitis just past sigmoid
Prednisone induced remission May 2012

Maintenance regime Pentasa - 3gm
Mesalazine Enema - every other day
Looking to reduce Pentasa orals in another month?

Elevit
Lysine
Limitted dairy & sugar
Couple wines here & there

quincy
Elite Member


Date Joined May 2003
Total Posts : 25590
   Posted 3/7/2013 2:09 AM (GMT -6)   
absolutely blame it on baby brain...it's a legit excuse/reason..

lol.
q
*Heather* I give suggestions, do with them what you will.
Status: ...Asacol 3 @ 2x daily; Salofalk enema @ 3rd night (nightly/ flares, tapered/maintenance)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol 20mg as needed; Zantac 150mg; Pulmicort/Airomir (asthma);Effexor XR 37.5 (depression)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care+Primadophilus Reuteri capsules @ bedtime)
~Metamucil capsules 6 twice daily with meals; Vitamin D 4500 IU
~URSO for PBC(or PSC?) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS" worth it !!!
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