Liver Enzyme Changes: Should You Stop Your Medication? - Gastroenterology and Hepatology

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When it comes to liver enzyme changes, particularly in the context of medication use, it is essential to approach the situation with caution and a thorough understanding of the underlying factors. In your case, you have been taking a medication called "得喜胃通" (likely a proton pump inhibitor or similar medication) for gastroesophageal reflux disease (GERD) and esophageal ulcers. You have observed an increase in your liver enzymes (GOT and GPT) from 23 and 25 to 35 and 47, respectively, along with a slight rise in creatinine levels.

Firstly, it is important to recognize that liver enzymes such as GOT (AST) and GPT (ALT) can be elevated for various reasons, including medication side effects, liver disease, alcohol consumption, and other underlying health conditions. In the context of medication, certain drugs can indeed cause liver enzyme elevations as a side effect. Proton pump inhibitors, while generally considered safe, have been associated with rare instances of liver enzyme abnormalities. However, the degree of elevation you are experiencing is relatively mild.

Before making any decisions about stopping your medication, it is crucial to consult with your healthcare provider. They can evaluate your overall health, review your medication history, and determine whether the observed changes in liver enzymes are indeed related to the medication or if they might be due to other factors. Your doctor may recommend additional tests, such as viral hepatitis screening or imaging studies, to rule out other potential causes of liver enzyme elevation.

If your healthcare provider suspects that the medication is contributing to the liver enzyme changes, they may suggest a temporary discontinuation of the drug to see if your liver enzymes return to baseline levels. In many cases, if the medication is the cause, liver enzymes can normalize after stopping the offending agent. However, it is also important to consider the potential for your underlying conditions (GERD and esophageal ulcers) to worsen if the medication is stopped. Therefore, your doctor may discuss alternative treatment options or adjustments to your current regimen to manage your symptoms while monitoring your liver function.

In terms of your concerns about symptom recurrence upon stopping the medication, it is a valid consideration. Many patients experience a return of GERD symptoms when proton pump inhibitors are discontinued. Your healthcare provider may suggest a gradual tapering of the medication or switching to a different class of medications, such as H2 receptor antagonists, which may have a lower risk of liver enzyme elevation.

In summary, while the increase in your liver enzymes could potentially be related to the medication you are taking, it is essential to work closely with your healthcare provider to determine the best course of action. They will consider your overall health, the severity of your symptoms, and the potential risks and benefits of continuing or discontinuing the medication. Monitoring your liver function and adjusting your treatment plan as necessary will help ensure that you manage both your liver health and your gastrointestinal symptoms effectively.