What causes pain at the bottom of rib cage and elevated liver enzyme levels?
Patient: Hello. I recently went to the doctor with moderate to severe pain at the bottom of my rib cage. My doctor ran some blood tests and found that my liver enzymes were twice the normal amount (I m not sure of the actual number, I am waiting to here back from the nurse) and my d-dimer was 550 or 5.5, I m not sure which it is (I had a double pulmonary embolism in 2009). I called the doctor to get my ultrasound report and the nurse told me that there was nothing new (I have 3 cysts somewhere, I am assuming on my gallbladder, but she did not say) and asked me if the stomach medicine the doctor gave me was helping. I told her no and she said she was going to call back the doctor. I am really worried that she will put me off like she has before and this pain will not go away. I am a 38-year old female who has hypothyroidism, fibromyalgia, and tachycardia that appears to cause my hypertension. I take Lopressor, levothroxine, and Lortab. What should I do and should I be worried? Doctor: Hello , thank you for your question ! Unfortunately i find it difficult to give you the best answer , because of the lack of information . You said your d-dimers are  5.5 or 550 mg/l . It is normal your d-dimers to be up to 0.5 mg/l . D-dimers are suggestive of trombosis and if you were my patient i would be really concerned about you ,if they are 5.5 . Pain in the upper part of the abdomen is suggestive of in first place of cholecystitis (infection of the gallblader with or without gallstones ) Ussually it produces nausea and vomiting . It can also be gastric ulcer or gastritis . If you have a hystory of gallblader infection , it is common to have infection of the pancreas , due to the connected lymp system . I strongly suggest you to see a doctor ( preferably Gastroenterologist ) for the final diagnose . You should undergo ultrasonography , blood tests and probably fibrogastroscopy . If you are not planning to see a doctor soon , you could start diet 1a (google it ) and take spasmolitics when in pain Hope that ould help you .Best regards!