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infection/inflammation - John was posted 07/05/2001 04:02 pm by Elizabeth W.
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John, I would like to add to the infection/inflammation possibility line by giving part of my story and my thinking. I had intermittent, small elevations of AST and ALT (liver function tests on standard blood chemistries) for 15 years before my stage 4A distal common bile duct cancer was found on my 52nd birthday. (I had pain near the navel for at least 5 years before the Whipple.) In those 15 years, I was tested for various liver diseases at various times and none of the tests were ever positive. Recently, I visited a liver specialist, Dr. Mezey, at JHH for another problem (turned out to be liver reaction to sepsis from bacterial overgrowth in Whipple 'blind loop') and I asked about my 15 year history of slightly elevated AST and ALT (and LDH as well). Dr. Mezey said I likely had intermittent blockages in my bile duct probably caused by infection/inflammation, and at those times the bile backed up into the liver to cause the elevated AST and ALT. Dr. Mezey said that if I had been his patient he would have watched me closely and found the bile duct cancer much sooner. That would have been great. But, I am in favor of removing the infection or source of inflammation before a cancer develops. Maybe you can figure out how to do it. I have talked with Dr. Hruban (the JHH pancreatic site) and he talks about using bile to test in the research setting. I too hope that further testing will confirm a benign process. Elizabeth

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