Nothing is lining up, elevated ALP, slightly elevated ALT, IBS symptoms

[Healthfreak4976]

Hello again,
I know, I keep posing about my health anxiety over the past few months, but I have many symptoms and nothing is adding up.

20 year old male, never smoked, drink, eats pretty healthy and quite active.

I have had so many tests done, a couple blood tests, colonoscopy, abdominal ultrasound, stool tests, and the results do not line up with my symptoms.

Here are my symptoms: (TMI warning!)
Alternating constipation (mild) and diarrhea (can be severe), I have not had diarrhea for a couple weeks now
Stool color keeps changing, rare that I have a brown stool, usually it’s orange, yellowish, greenish, or paler brown.
Oily film on the water after a bowel movement (does not look like olive oil but clear spots of oily film)
Lots of gas
Occasional aches in upper right abdomen, sometimes upper left
Symptoms worsened after eating meat, greasy foods, sometimes very quickly
Undigested food in stool (vegetables, chicken, tuna, etc.)
Lower belly pain when symptoms are flaring

Here are the test results:

SEPTEMBER BLOOD WORK 2022
Mostly normal,
Alkaline phosphate: HIGH 146IU/L (125 max)
Amylase HIGH 144IU/L (110 max)
Normal: ALT, AST, CBC, Lipase, bilirubin, negative for celiac, normal inflammatory markers

Stool inflammatory markers: 21 negative

JANUARY BLOOD WORK 2023
still mostly normal, BUT
Alkaline Phosphate has increased to 175IU/L in 4.5 months
ALT is now slightly elevated at 53 IU/L. (Max 46) it is not very elevated but to go from 27 to 53 in 4.5 months is kinda worrisome
Amylase: has dropped down to 112IU/L (max 110), it’s barely elevated and has dropped down since September so I feel good about that!
Slightly high heamoglobin
Slightly low CO2
Normal: AST, Bilirubin, CBC, still negative for celiac, lipase, normal inflammatory markers.

ABDOMINAL ULTRASOUND DECEMBER 2022
Normal liver, normal kidneys, normal bile duct, gallbladder basically normal except there is mild mucusal infolding, but that would not cause symptoms or off bloodwork right? Pancreas was also normal from what they could see, parts were obstructed, hearing this makes me feel great, but it still baffles me as why my bloodwork is off and why I have these symptoms.

COLONOSCOPY JANUARY 2023
Negative for Crohn’s, UC, MC, and any inflammation. 2 precancerous polyps were found and removed, (I feel so lucky about that) and they were nothing to do with my symptoms. Small internal piles. So basically besides getting really lucky with the polyps at my young age, the colonoscopy found nothing telling.

TESTS THAT HAVE NOT COME IN YET
Stool fat test to check for fat malabsorption
Stool elastase test to rule out pancreatic insufficiency (EPI)

I am so exhausted from worrying, and the new blood results have me worrying more. I’m very scared I’m going to need a liver biopsy and I don’t know how to cope with that. What would cause a gradual increase in ALP and a spontaneous ALT elevation?

I feel really happy that Colon cancer was ruled out and prevented, but I have been recently worrying about liver, pancreatic, and bile duct cancer, (I know extremely unlikely at my age) but I am scared because if I already have polyps at 20, how else is my body mutating?

It just does not make sense because I have symptoms of EVERYTHING, but every condition and test result has a give away symptom that I don’t have. I’m lost

I have been talking with my GP and my GI specialist about all my symptoms and they have been very good for me, GI thinks it’s IBS but wants to rule out fat malabsorption just in case. but with these new blood results it could have opened a whole new can of worms.

I really hope my liver is healthy lol

Please help me! I hate begging for it, but I’m spiraling again!

Thanks!

[Flapj]

First: calm down

Second: None of your tests are concerning. None. Slightly elevated liver enzymes happen. Beware of the trap of “chasing normal.”

Third: have you considered that your anxiety is causing digestive issues? Sounds like you have dumping syndrome. Have you tried fiber? Anti anxiety meds?

DO NOT get a liver biopsy. Completely unnecessary. You’re 20!

Are you drinking alcohol to self medicate the health anxiety?

[Healthfreak4976]

First: calm down

Second: None of your tests are concerning. None. Slightly elevated liver enzymes happen. Beware of the trap of “chasing normal.”

Third: have you considered that your anxiety is causing digestive issues? Sounds like you have dumping syndrome. Have you tried fiber? Anti anxiety meds?

DO NOT get a liver biopsy. Completely unnecessary. You’re 20!

Are you drinking alcohol to self medicate the health anxiety?

Thank you for replying!

I know that anxiety is a trigger for my symptoms but not always, usually 90% of the time it’s caused by stress or food, like meat and fried foods.

I try and eat a lot of fiber, but when I do, it causes more undigested food appearing with it, like chicken and so on.

Believe me, the LAST thing I want is a liver biopsy, but I got a second wave once my GI specialist told me that I had precancerous polyps in my colon at my very young age, but I feel very lucky because I have a long way to go until 45 so goodness knows what would have happened. But almost nobody gets colonoscopies at 20 either.

BUT I have good news! I got in touch with my GP and the lab was able to run a GGT test to distinguish whether the ALP is coming from the liver or bone. The result was 22 IU/L which is well within normal range. Which means the elevated ALP is not likely coming from the liver or biliary system, but rather bone.

I feel really good that my GGT was normal because it is very sensitive for liver damage/disease but now I’m more confused. I have always had strong bones and never bone issues, so how could it be? My red blood cell count, along with my hemoglobin are minimally elevated as well. What causes that?!

Again thank you for replying!

[golddustgirl1000]

1. Calm down - take it from me.. I’ve been dealing with HA since 14.. just came out of nowhere one night when I thought I had appendicitis and there went the now two decades long battle with anxiety. When I say it outloud wow.. thay is a long time.. I’ve been better as of a late but now it’s rearing it’s ugly head again.

2. Stress can cause a lot- did you know you actually have the most neurological pathways between your gut and brain? Yeah…

3. I’m preaching to the choir…